[HN Gopher] Anxiety, depression, and PTSD may be adaptive respon...
___________________________________________________________________
Anxiety, depression, and PTSD may be adaptive responses to
adversity: study
Author : firstbase
Score : 278 points
Date : 2020-09-03 09:00 UTC (14 hours ago)
(HTM) web link (www.psychologytoday.com)
(TXT) w3m dump (www.psychologytoday.com)
| podgaj wrote:
| As someone on disability with a mood disorder I can say without
| reservation that that article was mostly horrible.
|
| I will agree with them that there is a mismatch, but the mismatch
| is between each individuals genetics and environment. so they are
| still disorders, it is just that they have not found the right
| treatment.
|
| And as someone who has been hospitalized several times it is
| amazing to me how little testing they do for people with serious
| mental illnesses. It was not until after I had to learn genetics
| and neurobiology that I forced them to give me a simple serum
| amino acid test that showed something atypical was going on.
| Turned out I have a BH4 (tetrahydrobiopterin) deficiency that
| limits the amount of serotonin and dopamine I make. BH4
| deficiency has already been show to be a cause for anxiety and
| depression.
|
| So Mood Disorders are all environmental illnesses. I am off of
| all my medications and I control my mental health by diet and
| environmental changes. But some neurological damage has been done
| that I might have to live with. So you youngins heed my advice,
| if something feels bad, don't do it.
| kbos87 wrote:
| This feels so obvious. 30 years from now, we might very well look
| back at these labels we applied to people, implying something is
| wrong with them for responding to their negative circumstances,
| and feel like we were living in the dark ages.
|
| When we see historic rises in mental disorders following an
| external event like the coronavirus pandemic, is it not something
| we should reasonably expect? I can accept that some sliver of the
| population has an unreasonable reaction to something like this,
| but for most people, it isn't a problem in their head as modern
| psychology tends to imply.
|
| https://www.google.com/amp/s/www.washingtonpost.com/health/2...
| arethuza wrote:
| I remember reading about the first expeditions to the Artic by
| the Royal Navy in the 19th century - they initially found some
| sailors exhibiting the symptoms of being drunk and would punish
| them harshly. It took them a while to realise that the symptoms
| of severe hypothermia and drunkenness are actually pretty
| similar....
|
| See:
| https://www.goodreads.com/en/book/show/878082.Barrow_s_Boys
| Cthulhu_ wrote:
| I hope so, and that what we now call depression will be
| considered as silly a moniker as hysteria or "troubled humours"
| back when.
| proverbialbunny wrote:
| Exactly. When it comes to depression the chemical imbalance
| theory comes from Zoloft. It is a drug that accidentally had
| the side effect of reducing depression in some patients.
| Curious scientists wanted to figure out why, so they examined
| it. Turns out Zoloft boosts serotonin in the brain. This
| created the chemical imbalance theory, but since then study
| after study for decades has disproved this, yet for some sort
| of reason the theory stays in the mainstream.
|
| Ibuprofen can cause an ulcer. Imagine some primitive ape sees
| this blood loss and assumes the blood loss is what reduces
| inflammation. The Zoloft serotonin study follows the same
| faulty logic.
| SeanFerree wrote:
| This makes sense that ADHD could be a result from physical
| inactivity. Add the fact that most kids stare at a screen after
| school while also sitting. This could explain the increases in
| ADHD. Anxiety is a learned trait I believe. Increased depression
| seems to me to be due to social media, which allows people to
| constantly compare their life with others
| softwaredoug wrote:
| The ACE (adverse childhood experiences) study might be one of the
| most important health findings since Germ theory. In the sense
| that it finds a true root cause for a lot of health maladies, as
| well as physical mechanisms that cause these health issues in
| traumatized kid (all animals respond maladaptively to stress
| hormones introduced too early in development)
|
| I'd recommend people read "The Deepest Well" - a great book on
| this topic.
| throwaway4747l wrote:
| Ah yes, yet another occurence of adaptationists trying to
| shoehorn literally every single trait into their framework. It's
| basically intelligent design that doesn't say its name.
| whearyou wrote:
| No way! /s
| anonzzz wrote:
| "there is little in our evolutionary history that accounts for
| children sitting at desks quietly while watching a teacher do
| math equations at a board."
|
| In the section that discusses labels, I am particularly struck by
| this quote. So many things in our evolutionary history seem
| contrary to the way we live, learn, and interact. Perhaps this is
| the catalyst that ignites the evolutionary flames. I often think
| that we are just hitting our heads against a wall and expecting
| different results other than a bloody head.
| anm89 wrote:
| I'm not a psychologist but this feels pretty intuitively self
| evident to me. Did anyone ever think otherwise?
| mlthoughts2018 wrote:
| This is an interesting read on a similar take on major
| depression,
|
| https://grasshoppermouse.github.io/2018/12/16/seven-reasons-...
| solinent wrote:
| I used to get severely depressed, and it was often stress-
| related; adversity, work, even sickness would make things worse.
| I completely changed my lifestyle and started working out almost
| 3 hours a day (walking counts)in addition to removing
| carbohydrates from my diet almost entirely. After this change, I
| only get depressed for a second, then I realize I can take
| action, and then I take action, and it leads to happiness.
|
| YMMV.
|
| my personal theory is that it's related to bacteria in your gut--
| working out helps promote a good gut microbiome (this is well
| studied) and removing carbohydrates removes all those bacteria
| such as lactobactilla which will literally cause psychological
| changes, these bacteria are part of the metabolic process
| converting carbohydrates to blood glucose, and they are literally
| interacting with the nerves in your gut making you feel
| depressed. It's a biological thing. Psychology never helped me,
| instead it actively harmed me. The lectures of Robert Sapolsky
| and the concepts of cognitive behavioral therapy helped the most
| from the psychological perspective, however. This combination of
| advice is purely anecdotal of course, but all the steps I took
| have been widely studied. It's hard to create an industry around
| the removal of a product, I guess.
| insickness wrote:
| Trying to decide if mental disorders are disorders or adaptations
| is a false dichotomy. They can be both. For example, the 'dark
| triad', narcissism, Machiavellianism, and psychopathy, can help
| an individual succeed. Studies have shown that women are
| attracted to these personality traits in men.
|
| On a group level, anxiety in individuals may be evolutionarily
| advantageous to the group while being disadvantageous to the
| individual. If a person is hyper alert, it may help the group to
| become aware of danger but cause tremendous stress to the
| individual.
| proverbialbunny wrote:
| The key criteria for something to be called a psychological
| disorder is it has to hurt the patient in some way, causing
| them a disadvantage in life.
|
| To flesh this out:
|
| >Studies have shown that women are attracted to these
| personality traits in men.
|
| Woman are attracted to men who are as successful or are more
| successful as them. NPDs and ASPDs (though more rare than NPDs)
| can fake being successful and others fall for it. This
| relationship is often short lived once they realize they were
| tricked.
|
| The most common form of employment for someone who is ASPD
| (what you're calling psychopathy) is being a homeless
| alcoholic. The second most common is being in prison. The
| leading theory is ASPD is an adult who did not grow out of
| their terrible twos. This does not help an individual succeed
| in any shape or form. ASPDs do not and can not maintain
| relationships for a long period of time, and the few high
| functioning ones not in prison or homeless roam around like
| nomads from town to town leaving once they are no longer
| welcome.
|
| Machiavellianism is a philosophy or a set of beliefs. It is not
| a psychological disorder. It does not harm the belief holder.
| Machiavellianism is a sort of game theory on a macro nationwide
| scale.
|
| I can continue with NPD (narcissistic personality disorder),
| but I can assure you in the long run it does not benefit them.
| They believe manipulating people is better for them and will
| jump through mental hoops to justify their behavior to
| themselves. When someone is thought of as a con artist or a
| gold digger, that is most likely someone who is NPD.
|
| >On a group level, anxiety in individuals may be evolutionarily
| advantageous
|
| Anxiety is assuming (usually unconsciously) a negative outcome
| will happen. It's a danger feeling. When anxiety moves from a
| rare feeling to a disorder, it's because they're overly
| assuming/believing faulty futures. This can come from faulty
| logic, or being told incorrect beliefs during childhood, or
| many other situations. Anxiety as a disorder has no advantage
| to the user.
| tomhoward wrote:
| Out of necessity (after existing conventional treatments offered
| little help) I've been conducting a 10+ year self-experiment
| related to this topic.
|
| Like others have described, when I started experiencing symptoms
| of conditions resembling anxiety, depression, ADHD, mild bipolar,
| paranoia and CFS/ME, I initially sought mainstream medical
| psychiatric treatment and undertook talk therapy and was
| prescribed anti-anxiety (benzos) and antidepressant (SSRI)
| medications. There was some relief but there were also unpleasant
| side-effects, and I just had a strong feeling these treatments
| were not really addressing the core problems, and indeed I even
| felt like the symptoms were fairly normal reactions to the life
| experiences I'd endured.
|
| Later I tried to heal myself with nutritional and exercise-based
| approaches, and relatively conventional emotional approaches like
| meditation. Again, some mild/temporary improvements were
| noticeable, but they were inadequate, and it still felt like
| there was something deeper I needed to connect with.
|
| About 8 years ago, I found an approach that involves identifying
| and releasing traumas, attitudes, behavioural patterns, self-
| perceptions and defense mechanisms that are held in the
| subconscious mind, particularly ones that have been attained in
| early life and have snowballed through repetition compulsion [1]
| (a concept that Freud first articulated).
|
| I've been undertaking these approaches continually since I
| discovered them, and bit by bit all the symptoms have resolved.
|
| My experience has confirmed, at least to me, that these
| conditions are "adaptive responses to adversity" (or something
| else related to that concept), and that in order to heal the
| symptoms, I needed to understand their basis at a very deep
| level; as Jung said, "making the unconscious conscious" [2].
|
| Once that had been done, adopting new, healthy attitudes and
| behaviours and living free of those symptoms has been fairly
| easy; i.e., healthier behaviours just emerged naturally once the
| causes of the unhealthy behaviours were identified and
| understood.
|
| If any researchers or laypeople are interested to know more about
| the techniques I've used and the results I've experienced, I'm
| happy to be contacted (email address in profile). None of the
| approaches I've used or their underlying hypotheses are novel;
| it's been written/spoken about extensively by veteran experts on
| mind+body health including Mate and Bruce Lipton. But there
| doesn't seem to be much in the way formal studies into these
| concepts, so I'd be happy to connect with anyone working in the
| field or anyone else interested to explore further.
|
| [1] https://en.wikipedia.org/wiki/Repetition_compulsion
|
| [2] https://www.goodreads.com/quotes/44379-until-you-make-the-
| un...
| RankingMember wrote:
| Can you give us an example of one of the techniques you used?
| tomhoward wrote:
| https://news.ycombinator.com/item?id=24365937
| vanderZwan wrote:
| While I'm very happy that this worked out for you, and I'm also
| sure that your scenario will apply to others, maybe even many
| people, even then I have to add a word of caution: generalizing
| from the experiences of _one_ person to _all_ psychological
| conditions would be a scientifically unsound position to take
| (I know that this not what you are saying, but it is possible
| to walk away with that conclusion).
|
| For example, many of the issues that you mentioned (anxiety,
| depression, etc) are _symptoms_ that can have wildly varying
| causes. It 's similar to, say, a fever: if you have a fever it
| can be completely different reason than what causes it for
| someone else: one can develop a fever from an infection, or
| from stress alone - so a psychosomatic cause. It's even
| possible to have chronic fever due to brain damage! It has to
| be evaluated on a case-by-case basis
| tomhoward wrote:
| Sure, thanks, but remember we're adults here, and pretty well
| educated ones at that, so, the need for caution and
| discernment can be presumed to be understood by readers on
| this site :)
|
| For what it's worth, plenty of books have been written about
| these concepts over several decades; some authors include
| Gabor Mate, Bruce Lipton, Stanislav and Christina Grof, Peter
| Levine and Iain McGilchrist, all of whom have advanced
| academic credentials in psychiatry or biomedical science.
|
| So, yeah, there's no "generalizing from the experiences of
| one person to all psychological conditions"; there's sharing
| one anecdote as an example of what many experts have known
| for years (even if those experts' research findings aren't
| used much in formulating the DSM or applied by your average
| neighborhood psychiatrist, for reasons that are a whole other
| discussion!).
| phkahler wrote:
| I completely agree. In my experience, most therapists have been
| given very powerful tools but are not really equipped to handle
| them. It has led me to understanding these concepts much like
| you. As for this:
|
| as Jung said, "making the unconscious conscious"
|
| I may be misquoting but "until you make the unconcious
| concious, it will control you life and you will call it fate."
| Or something close to that. I agree, we often do things for
| reasons we dont fully understand. We can offer an explanation
| that sounds plausible, but there may well be more to it that
| even we haven't really explored.
| novok wrote:
| This is known as psychodynamic therapy for others who want a
| name for it. There are therapists that specialize in it. I must
| warn you its a very long type of therapy with a lot of
| sessions, so it will cost you $$$. Also some people use it as a
| weekly whining session for years and never get anywhere with
| it, so please go into it trying to get results.
| mettamage wrote:
| > Also some people use it as a weekly whining session for
| years and never get anywhere with it, so please go into it
| trying to get results.
|
| A bit harshly formulated, but I agree. I've seen people being
| quite aimless in their therapy. I'd recommend becoming an
| expert on your own condition.
| astrocat wrote:
| _The Trauma of the Gifted Child_ by Alice Miller is probably a
| good read to throw in here if this is the direction you 're
| looking to explore - especially if you can get an early edition
| that hasn't been watered down. Some of her perspectives into
| experiences as a child that are commonly accepted as "normal"
| but are often experienced by the child as trauma and grow into
| dysfunction as adults were interesting.
| Ancapistani wrote:
| Is it "Trauma" or "Drama"? The version I'm seeing on Amazon
| is "The Drama of the Gifted Child".
|
| ETA: I found this interesting, too - the author's own child
| wrote a book about his negative childhood experiences:
| https://www.haaretz.com/life/books/.premium-mother-
| dearest-1...
| thebean11 wrote:
| It's "Drama"
| kej wrote:
| >an approach that involves identifying and releasing traumas,
| attitudes, behavioural patterns, self-perceptions and defense
| mechanisms that are held in the subconscious mind
|
| Could you elaborate on this part? What does "identifying and
| releasing" look like, in practice?
| tomhoward wrote:
| Hehe, this is where discussions about this stuff can go off
| the rails, as the main modality I've used has links to the
| chiropractic profession (even though I think that profession
| is highly dysfunctional and many or even most of its
| practitioners are quacks at best and frauds at worst).
|
| Anyway, the modality I've used is a technique called NET
| (neuro-emotional technique), which (I believe) is similar to
| a practice called Psych-K (I've never done this one but I'm
| told they're similar). Both of them use muscle-testing to
| identify incongruences between the conscious and subconscious
| mind.
|
| I've also done plenty of Holotropic Breathwork and
| Ericksonian Hypnosis, some EMDR, some EFT/Tapping, and some
| use of basic affirmations. Someone else I know well has done
| a lot of a practice called Family Constellations, as well as
| another practice that focuses on healing the trauma of birth
| - though I've not done either of those practices.
| RankingMember wrote:
| Hey if worked for you, it worked for you. Thanks for laying
| it out there regardless of what I think of some of these
| techniques.
| iamdbtoo wrote:
| This has been my experience as well, but I found it through
| talk therapy, medication and some philosophy.
|
| Almost all of my negative emotions on a day to day basis are
| generated by defenses I developed as a child to make being a
| kid with undiagnosed ADHD workable. It worked while I was a
| kid, but became untenable as I got older.
|
| Once I discovered the ADHD as a basis for this thinking,
| everything started falling into place and as I started exposing
| these thought patterns to myself, they started going away.
| leto_ii wrote:
| Here's a personal anecdote of the moment when I realized that
| perhaps mental disorders are not disorders at all:
|
| A few years ago I had a job that made me deeply unhappy. The
| unhappiness came about gradually, but in my last year there it
| was overwhelming. In my last year on the job I spent a good chunk
| of my working hours holding back feelings of deep frustration and
| anger over how things were progressing and over how I was being
| treated by my boss and by a few coworkers. At times I considered
| going to see a therapist, but in the end I opted for a more
| direct solution - I spontaneously quit the job.
|
| Even though my financial situation became a lot less secure, my
| state of mind improved greatly. I started sleeping better, some
| stress related physical symptoms went away, I started working on
| personal projects that I had been neglecting etc.
|
| I'm pretty sure that, had I gone to the therapist, I would have
| been diagnosed with some sort of depressive disorder and probably
| would have been prescribed some sort of medication. I probably
| would have still been in the job I actually hated and I wouldn't
| have made as much progress in understanding what I actually
| wanted from my life.
| frizzx wrote:
| I had a similar situation, although I had already been
| diagnosed with anxiety and depression multiple times.
| Medication never had a positive impact other than temporary
| fixes for anxiety so I reject any daily antidepressents.
|
| Last year I was in a similar work situation but did decide to
| go to therapy as a kind of check to see if my feelings seemed
| warranted or if it was maybe something else.Ultimately decided
| to leave that job. It took 8 months for me to figure out what I
| wanted to do and actually start working again.
|
| Extremely happy I made those decisions as I've doubled my
| salary, left an industry that was wrecked by COVID and got into
| one that has had accelerated growth for the same reason. I
| think it's good to trust your instincts, even though we both
| made different decisions they seem to have been the right ones
| for our particular situations.
| slothtrop wrote:
| > I'm pretty sure that, had I gone to the therapist, I would
| have been diagnosed with some sort of depressive disorder and
| probably would have been prescribed some sort of medication
|
| 100%, everything is a nail to them. Diagnosis is really not
| that rigorous.
|
| It's amazing to me that the very first course of action
| suggested is not lifestyle changes, but medication. But money
| talks and here we are with over-medicated nations.
| podgaj wrote:
| This is like saying people with heart disease do not have a
| disease because they stopped eating poorly and the heart
| disease went away.
|
| You did have a metal disorder. You were just lucky to find the
| cause. The cause was job stress.
|
| I have a mental disorder that was harder to find the cause. But
| I did as well.
| leto_ii wrote:
| > You did have a metal disorder. You were just lucky to find
| the cause. The cause was job stress.
|
| You could phrase it that way, but the fact remains that for
| me, I feel, there was an objective external cause to my
| unhappiness. It wasn't a spontaneous and inexplicable
| 'chemical imbalance in the brain'. It was a reasonable
| reaction to a shitty life experience.
|
| > I have a mental disorder that was harder to find the cause.
| But I did as well.
|
| Indeed I may have stated my conclusion too broadly. I'm sure
| there are problems out there that can't be fixed by changing
| your lifestyle/job etc. and that may require serious effort,
| therapy, medication.
| podgaj wrote:
| But you see, I was hospitalized several times for my mood
| disorder. I have come to find out that there was an
| objective external cause of that as well.
|
| The problem is not with the psychiatric "cures", the
| problem is the psychiatrists. It took a test to LOOK at my
| brain chemistry form them to see what was going on with me.
| It took 25 years of convincing them to give me the test.
| THAt is the disorder.
|
| Shitty life experiences, and almost every environmental
| input, will affect chemicals in our brain and body. I mean,
| how do you think saddness happens? It just appears out of
| no where? NOPE.
|
| https://www.sciencedirect.com/science/article/abs/pii/S0165
| 0...
| proverbialbunny wrote:
| >Shitty life experiences, and almost every environmental
| input, will affect chemicals in our brain and body.
|
| I think that is a key point many people fail to see. Our
| present moment (including our thoughts and beliefs in the
| present moment) determine what chemicals get released in
| the brain.
|
| Calling something a chemical disorder is overlooking
| correlation is not causation. (That does not imply pills
| can not be helpful and should not be considered.)
|
| Did you end up finding a cure on your end? What was it?
| podgaj wrote:
| I was recently diagnosed with a genetic condition, GCH1
| deficiency, which lowers the amount of serotonin and
| dopamine I make and increases the amount of trace amines.
| (Trace amines are similar to methamphetamines.)
| maxlamb wrote:
| Heart disease means presence of plaque in arteries, it is
| physically verifiable, the plaque is physically stuck to the
| artery walls and is much harder to get rid of. If you are
| doing something that makes you unhappy because you really
| need the money and then as soon as you stop doing it you are
| happy again, I really don't see how you can define this
| period of unhappiness as a mental disease.
| anoncake wrote:
| Depression is not just being unhappy.
| proverbialbunny wrote:
| The sad fact about anti-depressants is they prolong depression
| for the average person who takes them. Yes, the average person
| recovers from depression without anti-depressants, but taking
| anti-depressants stifles that.
|
| I can only theorize, so grain of salt, but I've noticed people
| who are on anti-depressants are less likely to work on their
| issues, improving and growing. Many get satisfied in that semi-
| depressed state. This might be why taking an anti-depressant
| can prolong depression.
| ddorian43 wrote:
| Sorry man, the therapist can't prescribe. You are free to read
| "The body keeps the score" to understand why everything you
| wrote is wrong/false.
|
| To the downvoters:
|
| Things in life are in different levels. Your knee may hurt a
| little, you may tear 1 ACL in your knee, you tear all ligaments
| in your knee, your knee got chopped off, etc etc.
|
| Going to the doctor, doesn't 100% mean your knee will go into
| surgery. Sometimes, you may just need a professional consult,
| etc etc.
| leto_ii wrote:
| > everything you wrote is wrong/false.
|
| Well now, this is a bit too harsh. I presented my anecdote as
| such, not as some universal conclusion that applies to
| everybody and every life situation.
|
| > Going to the doctor, doesn't 100% mean your knee will go
| into surgery.
|
| You are right. I do however feel that psychiatry is not
| exactly as much of a science as other medical fields. I'm not
| convinced that what is considered a disorder according to the
| DSM is exactly as much a disorder as, let's say, a vision
| defect. I'm also really reluctant to try out medication that
| will alter my mood and mental acuity in unpredictable ways.
| As much as possible I would prefer to not take things for
| years and to not end up depending on them for good
| functioning in the world.
| [deleted]
| ferros wrote:
| Telling somebody else they are wrong about their own personal
| experience deserves a downvote, which I don't have enough
| points to give you.
| ddorian43 wrote:
| Here's a personal anecdote when I realized that perhaps
| "knee medical issues" are not "medical issues" at all:
|
| I was once running and my knee started hurting. I kept
| running and it kept hurting. I then saw that the reason my
| knee kept hurting was because I was using the wrong shoe,
| or was running not at the right form. After I changed
| these, the knee didn't hurt no more.
|
| _Had I gone to a physiotherapist or an orthopedist, they
| would 've put me into surgery for ACL/MLC reconstruction
| and 6+ months of therapy so my knee worked again._
|
| I would still be running after the surgery, not
| understanding why my knee would hurt. I wouldn't have made
| as much progress in understanding what I actually wanted
| from my knee.
| anoonmoose wrote:
| How do you know they wouldn't have told you to use better
| shoes or better form? This isn't even an anecdote, it's
| more like half of one.
| [deleted]
| tsimionescu wrote:
| The reason your assumption doesn't ring true while
| leto_ii's assumption does is that we have a much, much
| better understanding of the knee than we do of the human
| mind, and much more objective tests for knee injuries
| than for depressive disorders.
|
| So your assumption that you would have been given surgery
| seems extremely unlikely, while the assumption that a
| person with depressive symptoms would be prescribed
| psychiatric treatment rather than being recommended to
| leave their job seems possible.
|
| For your anecdote, I would expect that you would be given
| a physical exam and then some kind of imaging
| investigation before proceeding to surgery. Even if the
| doctor you went to was incompetent during the physical
| scan, the imaging would very quickly show whether there
| is a need for some kind of surgery. Unfortunately, we
| don't have any equivalent tests for psychiatric problems.
| If your psychiatrist is incompetent, you may well be
| prescribed medication that other psychiatrists may have
| found unnecessary, and your only recourse is to trust
| your own judgement above theirs (which has its own
| problems, if you already suspect you have a mental
| disorder).
|
| Of course, per their story, leto_ii didn't seek
| professional help, so we can't know what the professional
| conclusion would have been. Have you ever heard though of
| psychiatrists recommending job changes to their patients?
| More so, recommending they leave their job on the spot,
| without securing another job before hand?
| [deleted]
| JimTheMan wrote:
| I think people just need to realise that depression is going to
| come from when the stressors in our environment overwhelm our
| ability to cope. It's not just something that arises from out
| of nowhere for most people. For instance I bet a great swathe
| of the unemployed would not be depressed if they had a job.
|
| Sounds like you were able to adapt and start doing things that
| would reduce your stressors.
|
| However I don't think its a 100% correct to equate therapy with
| medication. If you visited a clinical psychologist they would
| have probably worked on increasing your awareness of stressors,
| thoughts and how to increase your ability to cope with them.
|
| Edit: And I just realised you may not have actually had a
| disorder of any type. A psychologist would have been able to
| assess you and see if you were just in an acute situation or
| not.
| bluntfang wrote:
| >For instance I bet a great swathe of the unemployed would
| not be depressed if they had a job.
|
| I think this is worth a rephrase. Something like:
|
| I bet a great swathe of people wouldn't be depressed if they
| didn't have to trade their time for food and housing tokens.
| JimTheMan wrote:
| I suppose I am speaking from experience. I feel no
| financial pressure but am greatly unhappy after being made
| redundant. Work gave me purpose that is hard to replace.
| podgaj wrote:
| I agree, and this is why I say the majority of mood
| disorders are environmental, even ones as bad as mine.
| nverno wrote:
| That is an unconvincing rephrasing though. The benefits of
| hard (rewarding?) work to mental health seem obvious [to me
| subjectively ofc]
| bluntfang wrote:
| It seems you're equating the requirement for a job with
| hard and rewarding work. What makes you think people
| won't do hard or rewarding work without the forced
| incentive of housing? What makes you think most people
| are doing "hard" and "rewarding" work at their jobs?
| nverno wrote:
| incentives drive outcomes- incentives to work cause
| people people to work [paid or unpaid, for pleasure or
| profit]. I wasn't making judgements on the reasons we
| need to work, only taking issue with the idea that
| working was causing depression.
| Cthulhu_ wrote:
| I've had something similar, not depression or whatever, just
| not feeling in the right place at work. I was offered an
| (external) career coach to help with it, also because I didn't
| really want to quit because it was a fairly cushy job with high
| potential to be challenging. But it hadn't been challenging or
| gratifying for two+ years at that point.
|
| The tldr with the career coach was to do more about it myself
| (very generic I know), eventually last year I looked for jobs
| critically and found one that ticked a lot of boxes. I'm pretty
| content right now.
| pessimizer wrote:
| > I probably would have still been in the job I actually hated
|
| If modern psychology has any goals, they are 1) to keep you at
| work with minimal days off and high productivity, and 2) to
| keep you from annoying your family. You would have been a
| success story.
| bmitc wrote:
| I would recommend people watch this lecture by Stanford professor
| Robert Sapolsky, who studies these things in depth and is an
| actual expert.
|
| https://www.youtube.com/watch?v=NOAgplgTxfc
|
| There is a lot of arm-chair thoughts on this matter in this
| thread, and I feel this lecture sets a lot of things straight.
|
| A helpful quote from the talk: "...the single point I want to
| hammer in here over, and over, and over, is something that people
| with depression constantly battle with. Back to semantics, we all
| get depressed. Bad stuff happens to us. We all get depressed. We
| feel lousy. We feel withdrawn. We feel a sense of grief. And
| we're not taking much pleasure. And we withdraw. And then we get
| better. We cope. We heal. We deal with things in life. What's the
| deal with you that you can't do that? And there's this lurking
| sense given that all of us have periods of being depressed and
| come out the other end. When you look at people who instead go
| down and stay down there to this crippling extent, there's always
| this little voice between the lines there of, come on, pull
| yourself together. We all deal with this sort of thing. I will
| make the argument throughout here that depression is as real of a
| biological disorder as is juvenile diabetes."
| bernardlunn wrote:
| This will help a lot of people avoid unnecessary anxiety and
| shame/guilt.
| heisenbit wrote:
| Insights from psychology today from an article originally in
| Forbes.
|
| About the Author: A pediatrician and writer, Dr. Escalante is on
| a mission...
| usgroup wrote:
| +1 but let's see where your comment ends up ranked in the
| thread at days' end.
| podgaj wrote:
| +2
|
| "Dr. Escalante understands because she is a recovering
| worried mother herself. "
|
| I am tired of people prescribing their cure to everyone else
| in the world. Great, it worked for her. And I get it, the
| whole world is neurotic, but to say it is not a disorder is
| idiotic.
|
| If I make a mess of my room, it is just disordered. It is
| just that simple.
| vanderZwan wrote:
| > _If ADHD is not a disorder, but a mismatch with a human
| environment, then suddenly it's not a medical issue. It's an
| issue for educational reform. And that is a compelling thought,
| given the evidence that kids' focus and cognition are improved by
| physical activity. Still, we need to take this study with a grain
| of salt. There is a large body of research showing other
| biological factors when it comes to ADHD. For instance, there is
| evidence that premature birth increases rates of ADHD later._
|
| So speaking as someone with adult ADHD who is getting by without
| medication with the right lifestyle choices, this sounds a bit
| like arguing that cardiovascular diseases are not medical issues,
| they're lifestyle problems.
|
| I mean, yeah, in both cases the problems very much _are_ largely
| caused by our lifestyles. But these lifestyles still affects me
| differently than how it affects most other people. Don 't get me
| wrong, I'd be very happy if we get rid of the _disorder_ label,
| not to mention societal stigmas surrounding mental illnesses and
| /or being neuro-atypical in general, but I don't see why we'd
| have to choose between (in this example) educational reform and
| psychiatric therapy when both seem valid options that complement
| each other.
|
| EDIT: also, if you _really_ want a good example of dystopian
| victim blaming in psychology, I 'd suggest checking out
| "opppositional defiant disorder" and imagining how _that_ label
| can be abused
|
| https://en.wikipedia.org/wiki/Oppositional_defiant_disorder
| podgaj wrote:
| Thank you, yes, I said the same thing in another reply.
|
| I am Bipolar getting by without meds. I do not have a disorder,
| I have a difference. So I need to live and eat differently.
| Pelic4n wrote:
| Sorry but that attitude is extremely dangerous. Maybe you
| have a less severe case that's manageable without treatment
| but that's not the case for everyone. Mania states are
| actively brain damaging and can blow into full-on psychosis.
| There is no lifestyle change, diet or essential oil that's
| going to stop that from happening for folks with a severe
| bipolar disorder, which is absolutely a disease since it
| destroys your brain if left unchecked.
|
| Spreading such misinformation can lead to people not seeking
| treatment and getting hurt. Your case is absolutely not the
| canonic case for people with bipolar disorder.
| ColanR wrote:
| > Spreading such misinformation can lead to people not
| seeking treatment and getting hurt.
|
| Misinformation? Unless you have expert knowledge in that
| domain - and unless the alternatives podgaj describes have
| been exhaustively eliminated by a body of peer-reviewed
| research - you have absolutely no justification to label
| that as misinformation.
| SketchySeaBeast wrote:
| > and unless the alternatives podgaj describes have been
| exhaustively eliminated by a body of peer-reviewed
| research - you have absolutely no justification to label
| that as misinformation.
|
| That's not how that should work. If I say that my farts
| cure cancer, it's not the job of peer-review research to
| disprove me, and until then we all just assume that the
| information I'm giving is good.
| ColanR wrote:
| > until then we all just assume that the information I'm
| giving is good.
|
| Fallacy of the excluded middle. There's other
| alternatives to a) saying it's outright false and b)
| saying it's outright true. I'm saying it shouldn't be
| labeled "misinformation" without extensive evidence to
| back it up, just as you're saying it shouldn't be labeled
| "truth" without the same level of evidence.
|
| Instead, it's actually possible that we could discuss the
| theory as if it _might_ be true, or false, until there 's
| sufficient evidence to rule out one or the other. It's
| Pelic4n's refusal to do this that I take issue with.
| SketchySeaBeast wrote:
| Ok, so misinformation may be too strong a word - really
| it's just unfounded, so that labeling IS wrong. I still
| think we need to treat it as false until we have evidence
| it works. I'm sure you wouldn't treat my farts as curing
| cancer if I made the claim unless there was proof.
| ColanR wrote:
| Glad we agree on the essentials. There was anecdotal
| evidence to back up the claim, however; it's not
| "unfounded." While that's not enough evidence to make any
| real claims, it is enough evidence to have a
| conversation.
|
| A conversation is a prelude to an exploration, and an
| exploration is a prelude to a hypothesis, which is the
| beginning of an experiment. An experiment is where we
| obtain the evidence to begin to say that it might be
| true, or false.
|
| It's entirely possible to think about something and even
| discuss it without labeling it as either true or false -
| to be simply agnostic. We don't need to jump to
| conclusions. If we aren't jumping to conclusions, then it
| would be incorrect to say that we treat it as false, just
| as it would be incorrect to say that we treat it as true.
| captainredbeard wrote:
| I recommend looking into the few longitudinal studies for
| dopaminergic illness involving anti-psychotics -- the new
| "front line" bipolar treatment -- and long term prognosis.
| The severity and frequency of episodes increases.
| podgaj wrote:
| Less sever case!!! Ahahahahhah! Uhm, no, I assure you this
| is not the case. Hospitalized four times, suicide attempts,
| psychosis, hallucination, on permanent disability, my
| mother and brothers have it and attempted suicide, my
| nephew, suicide. At one pint I was on lithium, zyprexa,
| lamictal, and prozac all at the same time. They also
| thought I had MS at times because of all the neurological
| stuff that was happening.
|
| You can say what you want, but they found I have problems
| metabolizing amino acids (BH4 deficiency) and this is fixed
| by a low protein diet. (More technically, I have GCH1
| deficiency.) Now I only need Klonopin in emergency cases.
| But watching my exposure to oxidative stressors is
| important because it destroys BH4.
|
| And you do not even know what causes Bipolar disorder so
| how the hell could you know what might help it? And this is
| another problem, no matter how good we feel with lifestyle
| changes, no one will believe us or even think we were ever
| sick. They tel me stress is a trigger for my illness yet
| they make me homeless and do not provide me with stable
| housing.
| Pelic4n wrote:
| Thanks for your insights and sorry for having supposed
| you had a less severe case, but all of that happened to
| you and you think it's not a disorder or a disease ?
| podgaj wrote:
| Disease: A particular distinctive process in the body
| with a specific cause and characteristic symptoms.
|
| Disorder: Irregularity, disturbance, or interruption of
| normal functions.
|
| Syndrome: A number of symptoms occurring together and
| characterizing a specific disease.
|
| I do not care which it is. I just focused on my symptoms
| and what made them worse and what made them better. To me
| is is a difference, that is the best way I can put it.
| tremon wrote:
| Stop labeling someone who doesn't want to be labeled.
| least wrote:
| Different treatments affect different people differently.
| This isn't particularly controversial, but the layman
| suggesting that they know better than scientists/doctors
| is kind of dangerous. There is of course room to be
| skeptical and ultimately you know what's going on better
| in your head than anyone else does, but that's not really
| actionable across an entire population of people
| suffering from something similar to you.
|
| It's also dangerous because you're telling people they
| don't have a problem they need to address and that if
| they do address it, they just need to eat differently,
| neither of which are applicable broadly to people with
| bipolar disorder. Medications that didn't work for you
| might work for them and are worth pursuing.
| proverbialbunny wrote:
| There is a problem with how we diagnosis illness today.
| We diagnose off of symptoms and symptoms only. The reason
| this is a problem is there can be multiple different
| things that cause identical or nearly identical symptoms.
| Today we think of those multiple things as one, but
| they're not one thing, they're different things. If they
| were the same, they would have the same cure.
|
| Parent knows he has a BH4 deficiency. Instead of calling
| that bi-polar, we could instead call it eg, 'bi-polar
| type 5' out of, say, 12, where 12 is the number of cures
| we've found for bipolar. Eventually, as time passes, we
| can map all if the cures, mapping all of the types.
| However, we can not do this if we think of an illness as
| a singular thing. This person has one specific type of
| bi-polar, and just because it only cures a subset of bi-
| polar patients does not mean it should be dismissed. It
| should be documented so we can have a list of cures.
|
| Once there is a list of cures a doctor can walk through
| this list and eventually find the correct cure for the
| patient. Once everything is mapped it becomes possible to
| have a 100% cure rate. This is something no single pill
| can do.
|
| This is why we should not force a one shoe fits all
| approach. It is toxic behavior to dismiss a solution just
| because it only works on a subset of patients. If I had
| bi-polar I'd be glad to know their story, so I could try
| it and see if it would work on myself. Dismissing
| psychological solutions is a toxic behavior we as a
| culture share. Let's do our part to make the world a
| better place and end this behavior.
| slothtrop wrote:
| > the layman suggesting that they know better than
| scientists/doctors is kind of dangerous
|
| That's a strawman.
| podgaj wrote:
| Thank you. Yes, a strawman and so frustrating since I
| literally have the metabolic and genetic proof that I
| found out what was causing my mood disorder. And as a
| result the doctors are providing better and different
| treatment. This what this "layman" discovered.
| least wrote:
| Do you or don't you have a disorder? In the first post
| you made in this thread you very clearly stated you
| don't. Now you're saying you do.
|
| The problem with your post is that you very discretely
| stated that you don't have a disorder even though you
| admit to being bipolar. Despite the fact that your
| "difference" has pushed you to suicide attempts,
| psychosis, and more. The fact that an effective treatment
| for you specifically was a low protein diet (which by
| your own admission still didn't remove the requirement
| for medication) doesn't make it not a disorder.
|
| The attitude is dangerous because you are spreading
| misinformation about something you are suffering from,
| which in turn can result in someone else being harmed.
| podgaj wrote:
| I only have the disorder when I have symptoms. You get
| it? Those symptoms are caused by my diet and environment.
|
| I am not "Bipolar" because everyone is bipolar, every one
| has these states, mine are just more extreme when faced
| with environmental challenges.
|
| If someone has a peanut allergy do they have a disease or
| a disorder? no, they have a different response when
| exposed to peanuts.
|
| I use the term Bipolar Disorder because that is what
| people understand and it is the current medical
| terminology.
|
| As far as your idiotic comment about the medication I
| need everyone and a while. Well, have you ever taken as
| aspirin for a headache? Same thing. The aspirin is only
| needed when you have a headache. Do you have a headache
| disorder still?
|
| What I am suffering from was clinically diagnosed. I am
| no longer considered by my doctors to have Bipolar
| Disorder. Isn't that crazy!? After 35 years of being told
| this?
| least wrote:
| > If someone has a peanut allergy do they have a disease
| or a disorder? no, they have a different response when
| exposed to peanuts.
|
| They have an "allergy," which is just another medical
| term like disease or disorder to define something which
| is abnormal which negatively affects life. If everyone
| had an "allergy" to peanuts then we'd just call them
| poisonous.
|
| > As far as your idiotic comment about the medication I
| need everyone and a while. Well, have you ever taken as
| aspirin for a headache? Same thing. The aspirin is only
| needed when you have a headache. Do you have a headache
| disorder still?
|
| No, because a headache is atypical, while bipolar
| disorder isn't, like other mental health issues. We
| define bipolar disorder differently from mood swings. If
| someone with epilepsy finds improvement in their
| condition from following a ketogenic diet, that is also
| them finding an effective treatment for their condition.
| It does not mean they don't have epilepsy.
|
| > What I am suffering from was clinically diagnosed. I am
| no longer considered by my doctors to have Bipolar
| Disorder. Isn't that crazy!? After 35 years of being told
| this?
|
| What's important ultimately is you found something that
| works for you and makes your life better for it. Your
| insights can be valuable but shouldn't be seen as
| prescriptive to people that aren't you.
| podgaj wrote:
| You say bipolar is atypical, but you are wrong. I can go
| months with no symptoms, just like people with headaches
| can go months without one. Then I have a trigger; stress,
| diet, pollution, etc.
|
| and I have never said that my fix was for everyone. Not
| once ever. It is that thinking that kept me sick for so
| many years in the hands of the psychiatrists.
| zepto wrote:
| The viewpoint that bipolar (and other brain differences)
| is a difference rather than a disorder can enable a
| person to have self compassion, and find peace and self
| acceptance, even though the condition will continue to
| affect them.
|
| The idea that it's a disorder and can be treated as such
| is a reasonable hypothesis for medical science to pursue,
| but that is all it is. Outside of that it's just a source
| of stigma and misinformation.
| least wrote:
| The viewpoint is based in the reality we live in where we
| stigmatize abnormality. The correct response isn't to try
| and normalize abnormality, but to try and remove the
| stigma surrounding it. Suggesting that it is normal
| actually creates a stigma for those who are suffering
| from it from pursuing treatment because they're supposed
| to feel that way because it's "normal."
| podgaj wrote:
| In no way do I think my symptoms are normal and just
| different. What I am saying is that what causes my
| symptoms is a different response to a similar
| environmental input that most people do not react to, ie,
| diet.
|
| I want you to consider it being like an allergy, not that
| I have some sort of histmagenic response, just that when
| you take my trigger away I have no symptoms.
| zepto wrote:
| Who said anything about normalizing abnormality?
|
| If by abnormality, you mean traits that are far from the
| center of a population normal distribution, then I agree
| that this is essential information for a person to have
| about themselves. Nobody is encouraging people to think
| they aren't different from the norm, when they in fact
| are.
|
| Abnormal, disordered, or diseased are very different
| things, and should not be confused.
|
| As for treatment - nobody should seek treatment because
| someone else has told them they are abnormal, or because
| they are not close to the center of the bell curve for a
| given trait. This is simply a bad reason.
|
| People should seek treatment if it will help improve
| their quality of life, _and_ they are willing to accept
| the trade-offs that come with it. Whether they are
| 'normal' or not is irrelevant.
| least wrote:
| > Who said anything about normalizing abnormality?
|
| It's implicit in the original comment i responded to.
|
| > If by abnormality, you mean traits that are far from
| the center of a population normal distribution, then I
| agree that this is essential information for a person to
| have about themselves. Nobody is encouraging people to
| think they aren't different from the norm, when they in
| fact are.
|
| People are encourage others to think they aren't
| different from the norm, this is prevalent throughout
| society at large, not just in cases of mental wellbeing.
|
| > Abnormal, disordered, or diseased are very different
| things, and should not be confused.
|
| Disorders and Diseases are both abnormalities.
|
| > As for treatment - nobody should seek treatment because
| someone else has told them they are abnormal, or because
| they are not close to the center of the bell curve for a
| given trait. This is simply a bad reason.
|
| This isn't true. Symptoms can manifest without an
| individual noticing it themself. Another trusted person
| telling you about these abnormalities to your behavior or
| physicality is a perfectly valid reason to seek
| treatment, even if it doesn't result in anything.
|
| > People should seek treatment if it will help improve
| their quality of life, and they are willing to accept the
| trade-offs that come with it. Whether they are 'normal'
| or not is irrelevant.
|
| Which was largely my point from the get go. The exception
| being cases where their lack of treatment being a danger
| to others.
| zepto wrote:
| You seem to be someone who has a very deep trust in
| medicine and in particular psychiatry to produce good
| outcomes for people.
|
| I can respect that difference of opinion.
| least wrote:
| I don't have a particularly deep trust in either medicine
| or psychiatry. My personal experiences with dealing with
| humans in either has been largely negative. That said, I
| largely attribute that to the people i've interacted with
| and not with medicine in general.
| Pelic4n wrote:
| >So speaking as someone with adult ADHD who is getting by
| without medication with the right lifestyle choices
|
| How do you do it exactly? Without ADHD medication I can't
| function on a basic level, and even then it's pretty hard. (Yes
| that's just ADHD, I tried every antidepressant and mood
| stabilizer under the sun for years before getting diagnosed
| with ADHD)
| vanderZwan wrote:
| Well, I have the inattentive subtype, without hyperactivity
| or much of the associated impulsivity. So I guess I'm already
| in a starting point that is easier to compensate for.
|
| I pay a _lot_ of attention to my sleep - I 'm a chronic
| insomniac. And keep in mind that it's not just about sleep
| time, it's also about sleep _quality_. So sleep hygiene is
| really crucial. No caffeine after lunch, and no alcohol in
| general (unless you know you can afford to be less well-
| rested the next day) because that might make you drowsy but
| it prevents entering the deep sleep cycle. Low-dosage
| melatonin seems to help me, not so much with falling asleep
| as it does with ensuring that once I _do_ manage to sleep, I
| hit that "deep sleep" cycle that is absolutely necessary to
| recover.
|
| I'm very sensitive to disturbances at night, noises can drive
| me _nuts_. So I spent a _lot_ of time finding comfortable
| ear-plugs. They are essential for uninterrupted sleep for me,
| which again is crucial for hitting the deep sleep cycle.
|
| Then there is the question of _falling_ asleep. If I have
| trouble with that (which is almost every night), I get out of
| bed and go read in the living room, so that my brain keeps
| associating the bedroom with rest. Sometimes I start having
| ideas just before falling asleep, I then try to write those
| down on paper, and maybe work them out a bit - I realized
| that part of why late night thinking keeps me awake is that I
| 'm afraid to forget all the ideas, so writing it down gives
| me peace, and doing so by hand also calms forces me to slow
| down. Meditation is also good for slowing down racing
| thoughts, but it really depends on what the thoughts in
| question are.
|
| Then there's diet. I don't know if I can generalize what
| works for me specifically, but lots of leafy greens in
| general. There is evidence that berries and other sources of
| polyphenols help a lot with children with ADHD, and in
| general those are supposedly really healthy, so I figure they
| won't hurt me either. Avoid things that give sugar
| rushes/crashes. Finally I take supplements for common
| deficiencies that apparently disproportionately affect people
| with ADHD (B, zinc, magnesium).
|
| Exercise helps because the cerebellum is involved with
| regulating attention. So I try to start the day with some
| mild exercise (like a short run) to really activate it. I've
| noticed that this helps with my attention regulation
| throughout the day. Sitting all day programming reduces
| activity again, so sometimes I take short "activation breaks"
| where I just do ten squats or burpees or whatever, not to
| exercise but to wake up the cerebellum.
|
| Therapy is important. The overlap between ADHD symptoms and
| co-morbid/complex PTSD symptoms is large, leading me to
| believe that maybe people with ADHD are just more likely to
| end up in traumatizing situations (in my case: other kids
| _loved_ to provoke temper tantrums in me) and part of their
| symptoms are really just a consequence of the resulting PTSD.
| As difficult as it was to process my past, therapy helped me
| a lot. It seems to have reduced some of my ADHD symptoms a
| bit, but even if it didn 't: someone with ADHD is likely to
| have a lot of pain to process as a result of their condition.
| Doing so means having one burden less to carry, making it
| easier to cope with the remaining issues.
|
| One very important thing I learned: ADHD means that
| _inevitably_ I will slip up at some point and forget an
| important appointment or something. The screw-up itself is
| punishment enough, so if I hate myself for always screwing up
| too I 'm just punishing myself twice. So learn to be kind to
| yourself and forgive yourself when that happens, that makes
| it easier to pick yourself up, fix the problem, and move on
| when this happens.
|
| Therapy also helped me with being better at being brutally
| honest about my limitations. No, I cannot plan five things in
| a day when I know that I can't complete more than two. If I
| know I'll likely forget _something_ at home when I go
| somewhere, even with checklists, leave early so I can go back
| to pick it up when I inevitably remember I forgot it five
| minutes after leaving the house. Try to develop good habits.
| More importantly, _only try to develop one habit at a time,
| and give it enough time to really become a habit._ And so on.
|
| And finally: use that ADHD hyperfocus to your advantage, and
| do deep dives into learning as much as you can about how to
| ADHD works and what you can do about it.
| podgaj wrote:
| And this is what I hate about these article, they leave
| people out in the cold who are suffering.
|
| Start with getting your genetics, your full genome if you can
| afford it. This is something that saved my life.
|
| Could be something as simple as nutrients, like B6 (P5P): htt
| ps://www.researchgate.net/profile/Marnina_Stimmel/publica...
| framecowbird wrote:
| I'm most surprised to learn that this _isn't_ the current
| prevailing view in the medical profession. I am not a doctor, but
| it's always seemed more natural to me to view depression and
| anxiety as adaptive behaviours - albeit perhaps ones that can end
| up being triggered too far.
|
| I read an article once (wish I could find it) that one advantage
| of mild depression was as sort a "call for help and support" from
| other embers of a close-knit social group, although I'm not sure
| how well-founded the claim was.
| DarkWiiPlayer wrote:
| I'm not a doctor, but I was also very surprised that this is
| "news" to the medical world. I has just always assumed that
| this was a well known thing, because it just seems completely
| logical to me.
|
| Just asking "what could the evolutionary purpose of depression
| be?" should already lead to the conclusion that it's most
| likely a mental defense mechanism, or byproduct of one, that
| can most likely be triggered by experiences rather than just be
| part of a persons genetics.
|
| But apparently it wasn't all that obvious after all.
| svachalek wrote:
| There are lots of obvious and completely logical things about
| the world, like the sun and planets go around the earth,
| animals cannot feel pain, and insects form spontaneously from
| rotten matter. But some of them are not correct despite being
| obvious and logical to everyone, and thus we have science.
| Avshalom wrote:
| There is no a priori reason to think depression has an
| "evolutionary purpose" any more than to think a broken bone
| does.
| [deleted]
| auganov wrote:
| Going with a very medicalized framework could very well be an
| adaptive behavior on part of the professionals too.
|
| The common sense approach makes it much harder to build a rich
| field of scientific looking knowledge and products.
| wittyreference wrote:
| Largely because articles like this generally focus on what I
| think of as "layman's depression", or "layman's anxiety." That
| is, a mild form of the condition that straddles the gray area
| between "personality" and "mild personality disorder," that
| diminishes quality of life in a perceptible but not devastating
| way.
|
| Then you go work on a psych floor and meet people whose
| depression is so severe it induces catatonia; people who look
| and feel like zombies and who would end their lives if given
| the chance; people whose depression comes with a healthy side-
| order of delusions. Extreme things that render someone
| incapable of even mild functioning.
|
| Or severe anxiety - patients whose worry comes from no external
| stimulant, renders them incapable of anything but physically
| sickening levels of worry, and if you manage to somehow help
| them reason through the thing they are currently worried about
| ... find a new thing to attach their emotions to. Look at
| something like OCD, wherein one - for instance - May
| obsessively wash hands to stymie an overpowering anxiety that
| ones house may burn down (OCD sometimes has logical triggers
| between ritual and anxiety; often not.)
|
| Interpreting that as "an adaptive response" is ridiculous.
|
| An adaptive response "taken too far", on the other hand, is the
| very definition of wide swaths of disease - autoimmune, cancer,
| etc.
|
| I find the "gosh it's just cultural mismatch" theory to be a
| modern stigma against mental disease. You can break any bone or
| system in the body - except for neuro/behavioral, that's just
| another type of person that needs some cultural adaptation.
| /That's/ never really broken.
| vmchale wrote:
| > I find the "gosh it's just cultural mismatch" theory to be
| a modern stigma against mental disease. You can break any
| bone or system in the body - except for neuro/behavioral,
| that's just another type of person that needs some cultural
| adaptation.
|
| Also ties into minimization of mental illness, which is a
| form of stigma!
| LatNax wrote:
| The examples you have given seem to be outliers where the
| system "human" broke out of its basic parameters, causing
| multiple other subsystems to fire out of control.
| 1_player wrote:
| How common is that extreme form of depression? Sounds like we
| need two different names for two very different diseases (or
| perhaps only one is actually a disease)
| podgaj wrote:
| There are no diseases, only symptoms. We can name diseases
| forever but that gets us nowhere. They just have more
| depression, or are more depressed.
|
| By the way, why don't people get SSRI's when they are
| depressed with a flu? I mean that is caused my lower
| serotonin as well. So for some reason we accept that
| depression because we have a reason for it?
|
| https://www.inverse.com/article/40843-what-f-lu-do-es-t-o-
| yo...
|
| You see, depression is fundamentally and immune disorder.
| We react negatively to something in the environment, like a
| bad job or marriage.
| elliekelly wrote:
| > You see, depression is fundamentally and immune
| disorder. We react negatively to something in the
| environment, like a bad job or marriage.
|
| This is an atrociously overly simplistic statement. There
| are plenty of people who suffer from depression despite
| having everything going for them. A person can have not a
| single thing in the world to complain about and still
| have depression.
| nitrogen wrote:
| I'd still argue that a person with "everything going for
| them" can still have a "reason" to be depressed. Maybe
| they do a really good duck impression -- calm on the
| surface, kicking frantically below. That is, maybe there
| is something wrong with their life or their past that
| isn't visible to others, or even to themselves. Or maybe
| they have been pursuing the checklists of society and
| found that they aren't personally fulfilled by them, and
| must seek fulfillment elsewhere. Maybe they have a desire
| to be living one kind of life but can only excel in a
| different kind of life that only looks good from the
| outside.
| zepto wrote:
| "A person can not have a single thing in the world to
| complain about"
|
| What person?
| podgaj wrote:
| Gautama Buddha! =)
| podgaj wrote:
| What about all the other things that might affect their
| immune system? Have they ruled them all out? Latent viral
| or bacterial infection? Allergies? Diet? Look at diet and
| Omega 6 consumption, that alone will screw with the
| immune system and throw the catecholamines off kilter.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950146/
| _jal wrote:
| > By the way, why don't people get SSRI's when they are
| depressed with a flu?
|
| One reason is SSRIs typically require a a few weeks to
| reach effective levels in your system; about how long it
| takes to recover from the flu.
|
| > depression is fundamentally and immune disorder
|
| You appear to be playing a free association game with
| words, not describing reality.
| podgaj wrote:
| The idea that it take weeks for antidepressants to reach
| 'effective levels" is a misunderstanding of the science.
| It is is true for MOST people that, for example,
| fluoxetine and its metabolite, norfluoxetine will be at a
| certain level in the serum before they have resolution of
| symptoms, but this is not the case for all people.
|
| It takes a very small dose to inhibit serotonin reuptake
| and this will happen with the first dose.
|
| https://www.nature.com/articles/1395757 "The single dose
| caused only a slight increase in drug plasma
| concentrations but relatively clear changes in sleep
| structure."
|
| And I was hoping you would all chime in and say it is
| useless for the flu. Because it might be very helpful
|
| https://www.sciencedaily.com/releases/2012/07/12072717191
| 9.h...
| SketchySeaBeast wrote:
| > You see, depression is fundamentally and immune
| disorder.
|
| That's a lot of certainty for something that is still
| very much uncertain.
|
| > By the way, why don't people get SSRI's when they are
| depressed with a flu?
|
| Because that's a short term, acute condition that will
| get better on its own? That's the same as saying "People
| in the hospital who can't breath are given oxygen, so why
| aren't runners who are breathing hard?" Because long term
| major depressive disorder is totally different than
| having a down couple of days.
| podgaj wrote:
| More certain than ever actually:
|
| https://www.sciencedirect.com/science/article/pii/S266635
| 462...
|
| Regarding oxygen use during running, it is already
| something: https://trainright.com/hyperoxic-training-
| little-know-traini...
| SketchySeaBeast wrote:
| As best I can tell there's not implication of causation
| there - it could be that depression causes the immune
| disorder, just as it causes any other number of
| conditions. I don't know the value in assuming we can
| categorize it like that.
|
| I assume with the oxygen thing you're intentionally
| missing my point which is that a regular momentary
| disruption isn't considered a disorder.
| podgaj wrote:
| I agree with you, depression alters the immune system and
| the immune system can cause depression. But it is through
| the immune system that we feel the effect.
|
| "momentary disruption isn't considered a disorder"
|
| By definition it is. Duration is irrelevant. My panic
| attacks can last for only 2 minutes.
| filleduchaos wrote:
| > That is, a mild form of the condition that straddles the
| gray area between "personality" and "mild personality
| disorder," that diminishes quality of life in a perceptible
| but not devastating way.
|
| I otherwise agree with your comment, but depression and
| anxiety aren't personality disorders or personality related
| at all. Depression is an affective disorder. Anxiety is its
| own class of disorder.
| wittyreference wrote:
| You're quite right. That was a typo/brain fart, and by the
| time I noticed it my comment was past editing.
| tremon wrote:
| _Interpreting that as "an adaptive response" is ridiculous.
|
| An adaptive response "taken too far", on the other hand, is
| the very definition of wide swaths of disease - autoimmune,
| cancer, etc._
|
| These two statements don't add up for me. If you do accept
| that various autoimmune disorders and cancers are essentially
| adaptive responses taken too far, then why can't depression
| similarly be considered the same? Or is your point that
| depression is simply an adaptive response, and it's not
| "taken too far" until people are at the catatonic state?
| novok wrote:
| You don't have depression if you really hate your job /
| university degree / sad your mom died, you just hate your
| job / sad your mom died.
| wittyreference wrote:
| Sorry, your question is fair -- let me elaborate:
|
| I feel the OP puts forward two statements, categorizing
| depression as "adaptive", or "adaptive response taken too
| far." I wish to address each of these separately.
|
| Having seen what these maladies do, I believe that
| categorizing them as "adaptive" is a position that can only
| be borne from "have never seen these diseases in their full
| spectrum, largely responding to mild, layman's-presented
| versions of them."
|
| Separately, addressing the concept of them being "adaptive
| responses being taken too far," I find essentially
| tautological. Give me a little leeway to oversimplify when
| I say that there are two broad categories of disease:
| exogenous (trauma, infection - things done to us by the
| external environment) and endogenous (things that occur
| from dysregulation of human physiology).
|
| ((Aside: the above is, like all models, _wrong_. There are
| interactions and predispositions between biology, exposure,
| etc. I aim to use the above to illustrate a point about
| "adaptive response gone too far", not to overlook the full
| biopsychosocial model of disease.))
|
| Calling a non-exogenous disease "an adaptive response taken
| too far" is a tautology. All human physiology arises from
| homeostasis - it's all "adaptive" in purpose, if not in
| effect. So all endogenous disease can be described as
| "adaptive response that is acting maladaptively."
| proverbialbunny wrote:
| This is horrible. If a therapist thinks depression is purely
| neurological then they will not try to cure the person and
| instead resort to talking to help comfort them.
|
| This view needs to change.
| johndevor wrote:
| I agree, especially since the ACE Study was released decades
| ago:
|
| https://en.wikipedia.org/wiki/Adverse_Childhood_Experiences_...
| [deleted]
| nunb wrote:
| Could the article have been by Robert Sapolsky? He discusses
| something like that in one of his later books, the one with a
| chimp on the cover where he talks about how male chimps leave
| their childhood tribes and head out to seek mates... and the
| adjustment of moving from a close-knit social group to a new
| alien group is covered.
|
| He's an endocrinologist/anthropologist by profession I think,
| but his books are sort of more about anthropology and
| psychology.
| throwaway57867 wrote:
| I went to therapy because of this. When I chose the therapist I
| focussed on choosing one that has a proper website and appears
| to use modern methods. Actually it was also the therapist's
| opinion that certain behaviours made sense at some point. In
| fact the therapy method didn't even require making a formal
| diagnosis because all these diagnoses are just summaries of
| statistics and not necessarily match the black box inside our
| head. Instead after the 3rd or 4th session I got a
| questionnaire in which I had to fill in what should be improved
| and what the goals should be.
|
| Also of course there was some kind of homework after each
| session. Usually the therapist then asked me how I could
| accomplish that goal. Then I came up with something and the
| therapist also told me "you are an expert for yourself, you
| know this best". That was both really surprising and
| encouraging. The therapy actually really improved my quality of
| life tenfold. I'm still wondering whether it was the method
| (Systemic therapy) or just the overall setup that made it so
| successful.
| hh3k0 wrote:
| I've read a similar article although with a different angle,
| stating that the advantage of depression is that members of a
| tribe which are a burden to the rest will eventually withdraw
| completely and/or kill themselves and therefore cease being a
| burden to the tribe. That said, I don't know how well-founded
| the claim was either.
| Voliokis wrote:
| It's hard to determine what our ancestors actually did. I'm
| sure you could argue any number of solutions they might have
| used. I'm wondering though what the prevalence is of these
| afflictions were back then or now in modern hunter-gatherer
| societies. The latter is not proof of anything, but it would
| be an indication of what a possibility might be like.
| browserface wrote:
| But this doesn't make economic sense. Billions could be lost
| from prescription revenues worldwide if this became the
| prevailing view. Hence, we will all continue to be "sick" and
| treatable with medication, rather than adaptively responding to
| adversity.
| raxxorrax wrote:
| Indeed. Although many practitioners are open about it that they
| cannot really influence those factors, so the try to offer the
| best individualized solutions to for respective patients.
|
| But to claim there are no environmental factors that might
| benefit depression is very likely just plain wrong. But in
| practice these factors are declared out of scope because
| neither patient nor psychologist can change those.
|
| Of course numbing yourself down with meds has other
| repercussions and maybe hinders that environmental factors are
| considered and changed.
| skissane wrote:
| There is a movement within psychiatry that wants to take a view
| similar to yours, although it is very much in a minority. I
| would point to figures such as the British psychiatrists Sami
| Timimi [1] and Joanna Moncrieff [2], associated with the groups
| "Council for Evidence-Based Psychiatry" [3] and "Critical
| Psychiatry Network" [4].
|
| The emphasise the ideas that psychotropic medications are
| overprescribed (they are not totally opposed to their use in
| all cases, but do think that the evidence for their benefit is
| often overstated, and the evidence of harmful side effects is
| often unfairly minimised), that the DSM-5 and ICD-10/11
| diagnostic manuals have very weak science behind them and
| encourage blaming the patient's brain for the patient's
| problems (in a very general way - advocates of the biological
| model can rarely point to anything specifically wrong with a
| given individual patient's brain, just the faith that some
| biological explanation is waiting to one day be discovered)
| even while ignoring the factors in the patient's social
| situation which may be a better explanation (but maybe a less
| socially convenient one - blaming the brain rather than the
| society eases society's conscience).
|
| [1] https://en.wikipedia.org/wiki/Sami_Timimi
|
| [2] https://joannamoncrieff.com
|
| [3] http://cepuk.org
|
| [4]
| https://web.archive.org/web/20200225204400/http://criticalps...
| frereubu wrote:
| One thing that I learned during my psychology degrees that
| always stuck with me was that mildly depressed people are
| measurably better at judging probabilities of things happening.
| (Unfortunately I can't remember off the top of my head the
| structure of the study, or how much better they were). I wonder
| if that might fit into this, in that if you're mildly depressed
| presumably bad things are happening to you, so perhaps it's
| adaptive to be more realistic about your situation. Pretty
| hand-wavy stuff, but interesting to think about.
| proverbialbunny wrote:
| Those who are successful in life have walked a path of
| failure, yet they keep getting up and trying again, learning
| from their mistakes and growing. This at its heart is a
| healthy kind of optimism.
|
| Those who call themselves a realist, who believe it will
| fail, shoot themselves in the foot, because they do not get
| to learn the valuable lesson that comes from that failure.
| Without trying and failing growth is stunted. Trying is a
| win-win. You either get what you aimed for, or you learn and
| grow.
|
| One scenario is if one grows up in a dangerous situation,
| you're shut down from risk taking, because taking a risk in a
| situation like that could seriously harm you. Meanwhile those
| who grew up in a safe environment could safely explore and
| open themselves up to positive hypotheticals worth
| attempting.
|
| Another scenario is that when one fails instead of learning
| how to do better next time they create an assumption that any
| remotely close scenario in the future will end in failure.
| When one believes a negative dangerous outcome will happen,
| and they're thrown into that situation, it creates anxiety.
| This is why anxiety and depression often go hand in hand.
| pessimizer wrote:
| https://en.wikipedia.org/wiki/Depressive_realism
| iamthepieman wrote:
| I struggle with mild depression, especially in the long
| winter months in the Northeast U.S. Anecdata, I know, but I'm
| much better at estimating times (arrival times, how long it
| will take to pack for a trip, when we will actually leave to
| get to an appointment) than my wife who is eternally
| optimistic.
|
| This comes in handy on estimating project times as well
| though only for me internally as most people don't want to
| hear realistic project times.
| raxxorrax wrote:
| I think there is also data that intelligent people are more
| susceptible to depression, so that might influence that
| result. Cannot find the source of it though.
| b0rsuk wrote:
| I remember reading an article like that. Also, it's a bit of
| a meme that if depression was 100% harmful then it would
| already be eliminated by evolution. I mean why shouldn't
| people prone to depression die off?
|
| Don't make a mistake, I'm still working on improving my life
| and uncovering the root causes. It is a silent thief of life.
| gowld wrote:
| The appendix is 100% harmful but not eliminated. As is
| nearsightedness.
|
| Evolution is only affected by genotypes that prevent
| reproduction.
| tremon wrote:
| That's a rather antiquated view. Nowadays, the appendix
| is considered an active organ again, essentially a
| spawning zone for the gut flora. I recall reading that
| people that still have their appendix have a more diverse
| gut microbiome, and more importantly, their gut flora
| recover more quickly after antibiotic treatments.
| tsimionescu wrote:
| > The appendix is 100% harmful
|
| It is not.
|
| Much better examples would be cancer and auto-immune
| diseases. Evolution is not magical, it can't produce 100%
| fault-free organisms. Or maybe it will, given a few more
| billion years. But in a limited time span, there is no
| reason to expect it to correct any potential flaw in an
| organism (and experience obviously shows that it hasn't).
| podgaj wrote:
| Uhm, no.
|
| https://academic.oup.com/mbe/article/35/12/2957/5112969
|
| "the strongest signals of recent human adaptation in
| Europe did not coincide with the Neolithic transition but
| with more recent changes in environment, diet, or
| efficiency of selection due to increases in effective
| population size."
| Nasrudith wrote:
| Evolution does not and cannot give a shit about you is why
| really. Elimination by evolution requires it to be both
| utterly nonviable and not tied to anything else. Look at
| sickle cell anemia - one copy protects against malaria via
| mild blood cell deformation. Two makes them concave.
|
| There are plenty of non-optimal things kept around because
| there isn't sufficient pressure to ensure it dies out.
| robotresearcher wrote:
| > Elimination by evolution requires it to be both utterly
| nonviable and not tied to anything else.
|
| Neither of those things are required. Any disadvantage to
| reproduction frequency of an allele can lead to its
| extinction. Even a 'good' allele can lose to a 'better'
| one.
|
| (The scare quotes are to acknowledge that these terms are
| just frequency re-stated)
| b0rsuk wrote:
| Or sinuses!
|
| An Annoying Quirk Of Our Evolution
|
| https://www.youtube.com/watch?v=WSSmJLb468k
|
| But what I meant is that according to the theory of
| evolution, individuals with disadvantageous traits
| reproduce less often. If they reproduce less often, they
| pass their genes less often. I think they say the trait
| is regressive.
| karlerss wrote:
| > I mean why shouldn't people prone to depression die off?
|
| "Having a child will make me happy". And hell, maybe it
| will - it's the perfect ruse by our genes - keep us
| depressed until we reproduce.
| grugagag wrote:
| Or maybe we leading a path in life with no meaning causes
| us to be depressed and seek a solution. Having a child
| puts one in the present moment and does give some meaning
| back though is not a cure for depression. I highly doubt
| the genetics make us depressed to have children.
| impendia wrote:
| I don't know who conducted the original study, but I remember
| that Martin Seligman opened his book _Learned Optimism_ with
| a discussion of an experiment exactly along these lines.
|
| Two groups of people -- a group of clinically depressed
| people, and a control group -- were asked to operate some
| apparatus that was programmed to fail a certain percent of
| the time. They were then asked to estimate how much actual
| control they had over the apparatus.
|
| The control group consistently overestimated, while the
| depressed people were spot on.
| silveroriole wrote:
| A try it yourself experiment: simply start giving accurate
| time estimates to project managers, and see how long it
| takes them to call you a pessimist :)
| jon-wood wrote:
| There's a general bucketing in the modern world of all
| unhappiness being depression that should be treated, which I
| don't think really fits what's going on. There are absolutely
| cases where anxiety and depression are a medical issue which
| warrant treatment with medication, but there are also
| completely legitimate reasons for those conditions. If your
| lifestyle is one of never leaving the house, zero social
| contact, with the bank imminently foreclosing on your house
| then depression and anxiety are entirely appropriate - so long
| as those feelings then cause you to do something about the
| problem.
| playeren wrote:
| I am a bit confused by your comment. When you write
| 'legitimate reasons', do you mean from a _moral_ stand point?
| I can't otherwise make sense of 'legitimacy' in this context.
|
| edit: Do you mean 'legitimate' in the context of it
| increasing evolutionary fitness in some way?
| agumonkey wrote:
| Seems like depression is like tissue regeneration. It tries
| to fix things then it bails out. Depression is often called a
| pit, when you're in it, you haven't the slightest idea nor
| capability to do whatever. The only evolutionnary value I see
| in this is making you so sluggish you'll be left out by
| whoever or whatever is harming you because time goes on and
| they'll move.
| Fishysoup wrote:
| Naming these two medical conditions "Depression" and
| "Anxiety" is pretty unfortunate. They are completely
| different from"feeling depressed" and "feeling anxious".
| Having depression or anxiety in the medical sense will not
| cause you to do anything about any problem, because they are
| debilitating. They reflect long-term changes to your brain
| chemistry that may or may not respond to medication -
| transiently feeling anxious or depressed is not that.
| DanBC wrote:
| > I'm most surprised to learn that this _isn't_ the current
| prevailing view in the medical profession.
|
| In the UK I speak to very many mental health care
| professionals, and I've only ever met one who pushed the
| biological model above the bio-psycho-social model. Everyone
| else is keenly aware of the wider determinants of mental
| health.
|
| There's some attempt to build this into the system, but it's
| pretty difficult because of the way the NHS and Public Health
| are set up at the moment. There's a lot of regional variation.
| johnchristopher wrote:
| > I read an article once (wish I could find it) that one
| advantage of mild depression was as sort a "call for help and
| support" from other embers of a close-knit social group,
| although I'm not sure how well-founded the claim was.
|
| In the same vein I also read something about how depression
| helps in momentarily retiring from the group to be perceived as
| a non-threat and the rumination is the symptom of a brain
| dedicating resources to finding solutions to a problem. Pop
| psychology most likely I suppose.
| raducu wrote:
| Because this actually IS the prevailing view, but it is not
| really actionable.
|
| What is the alternative to drugs?
|
| A real advantage of depression is you won't challenge authority
| so you'll be more likely to appease the Alpha members of the
| group.
|
| So what?
|
| How would this help a doctor treat a mental health patient?
| themgt wrote:
| I would look at other fields of medicine, e.g. research
| around how certain diets and fasting protocols can reverse
| metabolic syndrome and type-ii diabetes along with a variety
| of other positive health benefits.
|
| So what is a major focus of research? Finding ways to
| isolate/synthesize specific compounds to make a patentable
| drug that can be given in lieu of patients making lifestyle
| changes, because a) you can't patent a lifestyle change and
| put it in a pill and make billions of dollars off it and b)
| because patients are generally assumed to be unwilling/unable
| to make the lifestyle changes.
|
| So, "how would this help a doctor treat a mental health
| patient?" is perhaps the wrong question, because it won't
| because the doctor isn't interested or trained nor has the
| time to guide a person through a lifestyle change. It
| nonetheless may be very relevant to _you_ in deciding whether
| you 'd rather be on insulin for the rest of your life vs.
| finding a way to lose weight. Just as it may be helpful for
| you to consider whether makes changes to lower/resolve
| sources of stress and anxiety in your life is a better option
| for managing mental distress than being on an SSRI/benzo
| indefinitely.
|
| I wouldn't hold my breath waiting for the AstraZeneca "how to
| be happy without psychopharmaceuticals" guide to living.
| tokai wrote:
| > A real advantage of depression is you won't challenge
| authority
|
| Not true. It can give a fatalistic outlook and raise
| aggression. I know a (depressed) guy that almost got himself
| killed in traffic, because he would rather die than yielding
| to a pushy road user.
| nerdponx wrote:
| A combination of targeted therapy and short courses of drugs
| designed to ease the therapy process and control symptoms in
| the short term?
| InfiniteRand wrote:
| In my experience most psychiatrists recommend some form of
| talk therapy in addition to medication and my impression is
| that the consensus view is medications + therapy are more
| effective than either by themselves (also recommended are
| exercising , sleeping well, and other general health stuff
| most doctors lecture their patients about)
| Red_Leaves_Flyy wrote:
| What you you suggest doctors do when short term treatment
| regimens become decades long?
|
| If only the symptoms are treated it is illogical to expect
| the condition to go away. In fact, it's likely to get
| worse.
| raducu wrote:
| That is also common knowledge and practice.
|
| My point when I said it is not actionable -- was that
| removing adversity is actually impossible most of the time,
| the therapist/psychiatrist has to give the client/patient
| the tools so he can help himself out, to better cope with
| adversity.
|
| The therapist knows you're anxious because you had shitty
| parents, because you have a shitty boss and so on and so
| on, but that knowledge in itself is not actionable.
|
| It would be great if we all stopped being pricks to one
| another, make a big circle and hug eachother, but since
| that's not going to happen anytime soon, we have to learn
| how to cope with adversity.
| pessimizer wrote:
| > What is the alternative to drugs?
|
| A social safety net. A society that thinks providing the
| communication resources and facilities for people with common
| interests to socialize about those interests is as important
| as providing highways.
|
| > How would this help a doctor treat a mental health patient?
|
| You don't have to be a doctor to dispense pills. You can
| always anesthetize people who are panicking, but I'm not sure
| that should be called "treatment."
|
| Talking therapy probably works because it's the opportunity
| to talk to someone with no ulterior motives at length about
| your problems. We could provide that.
| gowld wrote:
| > facilities for people with common interests to socialize
| about those interests
|
| We have that. It's even _called_ a highway! The information
| superhighway.
|
| It hasn't cured depression and anxiety, and may have
| worsened it.
| raducu wrote:
| > A social safety net.
|
| I believe this would be great. But perhaps not, perhaps
| this was only in the what Ovid calls the Golden Age --
| perhaps small communities of hunter-gatherers, perhaps
| never in the way we imagined.
|
| But I don't see this happening unless we revert to much
| smaller communities.
|
| I think we could realistically cut world military spending
| by 90% before we could offer everybody that social safety
| net.
|
| So we DO need pills, because we cannot realistically offer
| 1 in X the support they need, the best we can do is offer
| pills that work long enough that they help themselves or
| some psychotherapy.
|
| Psychotherapy can be greatly helped in a lot of cases by
| pills.
|
| I have seen the light when I started experimenting with
| drugs(illegal and legal) -- it is such an incredible
| release to know you have the power to change your mental
| state, even if chemically.
|
| Having a Xanax in my walled, completely stopped my panic
| attacks, I haven't had one in years.
| slfnflctd wrote:
| At first I viewed the depression I started fighting in my teens
| as a scourge, a defect, something broken to be fixed.
|
| I have since come to see it as an important signal. When I am
| managing my life and mental states well, it often fades into the
| background. When it starts to flare up, like with some kind of
| physical pain, that's telling me I need to pay attention and
| change things up a bit.
|
| Furthermore - and perhaps most importantly - it is a preferred
| failure mode to freaking out or engaging in suicidal ideation.
| When I'm overwhelmed by that gloom, I remind myself that I could
| have a stroke, aneurysm or heart attack at any moment, and I
| think about what the consequences would be if I did. As long as
| I'm in a safe situation, I can simply take my first opportunity
| to Just. Stop. Taking time to shut down, and to cease forcing
| yourself to engage with a world that would go on without you if
| you suddenly died, is a good idea now & then.
|
| Yeah, at times I feel some twinges of guilt for doing this. It
| seems selfish on the surface. But when you compare it to the
| alternatives, well-- it's better than being dead, isn't it? I
| feel like my ability to manage my life (and depression) has
| improved considerably with this insight. If you need to stop,
| stop. Rest. Let whatever is pushing you to the brink simmer in a
| corner for a while, provided it is physically safe to do so. You
| will be better equipped to deal with it when you've had a chance
| to breathe, and to remind yourself that a temporary shutdown is
| indeed better than being dead.
| podgaj wrote:
| Do you realize these two sentences say the same exact thing?
| You have a pain, which is a signal of a disorder, and you need
| to change something to fix it.
|
| "At first I viewed the depression I started fighting in my
| teens as a scourge, a defect, something broken to be fixed."
|
| "I have since come to see it as an important signal. When I am
| managing my life and mental states well, it often fades into
| the background. When it starts to flare up, like with some kind
| of physical pain, that's telling me I need to pay attention and
| change things up a bit."
| typicalset wrote:
| I think these two sentences are different: it's analogous to
| treating a symptom vs treating an underlying condition.
| podgaj wrote:
| Yeah, I agree with that distinction. This is am important
| semantic discussion.
|
| But he just changed the name of the thing he wants to get
| rid of from "pain" to "signal". The signal is still a
| disorder. The signal is the thing that bothers us.
| abdullahkhalids wrote:
| I think they is saying that if you put your hand on a hot
| thing, you get a signal. You can also call it pain. But
| the problem is not an internal problem with your body,
| but a consequence of your environment. So change your
| environment or what you are doing and the pain will
| disappear. Don't try to keep your environment the same
| and try to change within.
|
| (I don't entirely agree with them, but that's my best
| summary of their argument).
| Solstinox wrote:
| No. One sees the depression as something to be fixed, the
| other sees the underlying problem causing the depression as
| something to be fixed.
| podgaj wrote:
| Yeah, I agree. But the signal is still the disorder that
| needs to be fixed.
|
| Any psychiatrist will tell you that psychiatric medications
| only treat the symptoms of mood disorders and that they do
| not know the cause of most of them. It is hogwash that they
| think mood disorders are "only chemical imbalances in the
| brain". They know these disorders are polygenic and
| environmental. But for some people, a short dose of SSRI's
| or antipsychotics can keep them alive long enough to find
| out what it is that is giving them so much pain, i mean
| singnals.
| bluntfang wrote:
| >It is hogwash that they think mood disorders are "only
| chemical imbalances in the brain".
|
| Who are you quoting here? What psychiatrists think this?
| AFAIK, this hasn't been the meta for a long time.
| podgaj wrote:
| No, I agree with you. I do not find psychiatrists believe
| that mood disorders are only chemical imbalances in the
| brain.
| zepto wrote:
| I have come across people have been led to believe it's a
| chemical imbalance by psychiatrists, even in the last few
| years.
|
| It may not be the modern psychiatric view, but it's also
| true that psychiatrists are just doctors, and many of
| them are very slow to change from what they were taught
| in medical school.
| agumonkey wrote:
| it's a default API for brains, but ideas will trigger
| neurochemistry too .. well I'm sure you got that already
| perl4ever wrote:
| I can't speak to exactly who uses this terminology, and I
| have not heard it from a medical professional, but I feel
| like it lingers on, like in medication pamphlets.
|
| Because fundamentally, I think, it is necessary to try to
| get people to comply with medication that seems to help
| sometimes, while avoiding the reality that the way it
| works is not known.
| User23 wrote:
| Amphetamines have shown some promising results in
| actually curing depression. There is a vicious cycle of
| depression where the anhedonia and lack of motivation
| cause the sufferer to allow the underlying causes to get
| even worse leading to deeper depression. Amphetamines can
| help break that cycle and ideally even start a virtuous
| cycle where their use can be tapered and eventually
| discontinued. It's vitally important though that the drug
| treatment is combined with behavioral modification so
| that the artificial stimulation of reward circuits can be
| operant conditioned on behavior patterns that mitigate
| the underlying cause of depression. Anyhow I might be off
| on the jargon since college psychology was a long time
| ago, but the basic concept strikes me as highly plausible
| and consistent with what we know about the human mind.
| And anecdotally I have friends who benefited from
| amphetamines for depression.
|
| However used improperly it can end in amphetamine
| addiction or even psychosis. It's not surprising most
| mainstream psychiatrists don't like to use them for
| depression, but it is a powerful tool in the box.
| volkl48 wrote:
| That seems perfectly reasonable to me as a line of
| reasoning, and I'm not casting doubt on whether it could
| work.
|
| With that said, I also wonder how many of those people
| had undiagnosed ADHD/if such studies involved screening
| for ADHD.
|
| Unmanaged ADHD leading to consistent failures in life and
| other difficulties -> depression/depressive symptoms from
| the consequences, lack of achievement, etc over the long
| term, is a pretty common story.
|
| And obviously, the responsiveness of those with ADHD to
| stimulants is pretty well-known.
| [deleted]
| dsego wrote:
| > However used improperly it can end in amphetamine
| addiction or even psychosis.
|
| Someone I know managed to do that, despite being on
| intramuscular antipsychotics. Unfortunately no middle
| ground, the meds keep him anhedonic and abulic, but
| without them it's mania. I would be careful with
| stimulants.
| montagg wrote:
| Are you familiar with what it's like to have depression?
| It's not something you can really ever get rid of, even
| if you can mitigate it with medication and lifestyle
| changes. It's there, though not dominant, even when
| things are going well and even when you're in a positive
| mood.
|
| I struggle with similar feelings, and the idea that
| depression becomes something that is there but can be put
| to positive use absolutely tracks with my own experience.
| BurningFrog wrote:
| > _Are you familiar with what it's like to have
| depression?_
|
| Pretty sure there are _many_ distinct conditions that we
| now call "depression".
|
| Your description is very true for some of them, and not
| at all for others.
| Delk wrote:
| This probably varies by the person.
|
| Some people might get a single episode, then get through
| it one way or another, and never have another one.
|
| Others might have a lifelong tendency or vulnerability to
| it, and in that sense it might always be there in the
| background. I'm fairly certain I was more or less
| depressed (although not diagnosed) in my teenage years
| and early 20's. In my later 20's things were brighter,
| although I probably had a tendency for some amount of
| depression, especially during the darker winter months of
| the year (I live in the north). However, there were
| definitely times when I wouldn't have considered myself
| depressed. I'm not sure I'd even say it was "there" at
| those times, in the sense of being actively present in
| any way, even in a non-dominant way.
|
| Later on, I got another deeper episode of depression that
| I'm still battling.
|
| Yet other people might have it always there in some way,
| as you say.
| podgaj wrote:
| Please read my other posts. I have a 35 year history of
| hospitalizations for both manic and depressive episodes
| and I have attempted suicide twice. I have lived with 9
| month long depressions where all I could do was watch
| cartoons and not enough energy to even brush my teeth.
|
| If one cannot get rid of depression then one cannot get
| rid of heart disease or cancer.
| throwaway_pdp09 wrote:
| I had it a large chunk of my life. It went, eventually.
| It can go but that's because it's not in my
| nature/mind/brain/chemistry/whatever. In this I'm very
| fortunate, but please don't completely rule out defeating
| it, though the odds are poor.
| TheAdamAndChe wrote:
| I think depression can spiral into a positive feedback
| loop that forms a depressive disorder. Mood affects life
| which affects mood which affects life...
|
| Many people who haven't been stuck in that positive
| feedback loop have still been blue. Their capacity to
| feel happiness is muted just like ours, but they are
| successfully able to get out of that with a behavioral
| change. That's not always the case with a depressive
| disorder, and it can take a multi-faceted approach of
| medications, lifestyle change, sleep hygiene improvement,
| sometimes electroshock therapy for those people to get
| out of it.
| GreenWatermelon wrote:
| Is it really better than death? to me, death means salvation,
| I'll no longer have to deal with troubles.
| baron_harkonnen wrote:
| "It is not worth the bother of killing yourself, since you
| always kill yourself too late."
|
| -- E. Cioran
|
| The trouble with "death means salvation", and believe me I
| know that yearning, is that you don't get to experience this
| salvation. Suicide is literally not the answer, because you
| will never get to experience the relief on the other end.
| This is the essence of Cioran's quote here. It would have
| been better to not exist, but it's too late for that now and
| ceasing to exist will not, in fact, afford you any sense of
| relief. The only relief you feel is in the fantasizing about
| death itself.
|
| Eventually you will die and after that point it won't matter
| how long or how painfully you've lived. From the perspective
| of death life doesn't matter at all, but you won't be alive
| to experience that perspective.
| 3pt14159 wrote:
| Believe me, I know what it is to suffer. But even though I
| lean against suicide strongly since I've lived the whole
| "if you're going through hell keep going" thing, and the
| relief when the (years long) suffering is over is immense.
| However, I struggle with things like a suicide pill given
| to air force pilots.
|
| Would it be better to be tortured for years? To have your
| family knowing that your fingernails got ripped out? That
| you lost your genitals to electrocution?
|
| I'm not sure. Plenty of heroes committed suicide.
| leetcrew wrote:
| > However, I struggle with things like a suicide pill
| given to air force pilots.
|
| it does raise an interesting, if morbid question.
| personally, I think it is fine for someone to kill
| themselves (or receive assistance in doing so) if they
| are facing a near certainty of terrible suffering for the
| rest of their life. the tricky part is the "certainty"
| bit. many people experience varying degrees of suffering
| at some point in their lives, but it is uncommon for it
| to persist throughout their entire lives.
|
| if you are interested in a way to sidestep this specific
| question, I would point out that the pills are not only
| for the benefit of the pilots. the measure is also to
| protect others who might be harmed by information
| divulged under interrogation.
| agumonkey wrote:
| If GP meant what I think he meant and he did manage to swim
| out of troubled waters.. I think yeah. And in general I
| remember that I was born to survive not to die. That every
| tuesday I get a happy moment.. so things are not fully
| broken. But I need to remove the noxious part of my life so
| more happy moments come than sad ones.
|
| Again it's not a universal solution but very often when you
| change context, you find yourself having it easier. You're
| not even trying to be happy, it just grows around.
| hexxiiiz wrote:
| This may make sense for you in particular, but it a lot of
| people the signal provided by depression is distinct in its
| persistent alarm about something that isn't really in the
| present. Listening to the signal and stopping to take stock of
| it and make changes is often what makes depression so
| paralyzing, since it is characteristic of it that this doesnt
| help. Depression for most people is that "stop, stop, rest"
| happening indefinitely. This is not to say that what works for
| you doesn't work for you. But, in general, treating depression
| like an important signal of something really wrong in one's
| life that one needs to stop and address before moving forward
| is pretty much depression itself.
| xhrpost wrote:
| Interesting counterpoint, but if you don't make changes then,
| aren't you just trying harder at the same thing every day,
| expecting different results? I guess I sympathize with OP as
| "try harder tomorrow" just hasn't seemed to work for me. What
| is it you're suggesting if stop and rest is actually the
| wrong thing to do?
| burkaman wrote:
| I think it's different for everyone, but therapy and/or
| drugs are often effective when your own efforts aren't
| enough. "Stop and rest" is not the wrong thing to do
| though, it just might not help.
| sassycassie wrote:
| good points
| golergka wrote:
| > about something that isn't really in the present
|
| Or is it? Therapy, especially gestalt or existential, often
| makes people realise that something really is off with their
| outlook on life, relationships with other people or other
| things like this -- something that they had paid no attention
| to and perceived as "normal", that really wasn't. And in the
| end, what started as their fight against depression ended up
| as work to fix the core reason for which that depression was
| only a symptom.
|
| I know this to be the case with myself and some close friends
| of mine. I'm not a health professional, and this is anecdotal
| evidence, but from talking to other people and therapists, I
| hear about this quite often.
| jiggybling wrote:
| Can you give an example, personal or otherwise?
| cbanek wrote:
| Not the OP, but I'm in therapy personally, and just as a
| personal example, didn't realize that some current
| reactions and feelings were colored by past experiences.
| In particular, this has to do with patterns I hadn't
| noticed across different relationships and work. Like my
| pathological independence and general lack of trust in
| humanity.
| taurath wrote:
| Often the "answers" to why one is depressed can be hidden
| under many layers. It can be from a psychological source,
| a physiological/neurological source (an injury, etc), or
| a physiological source BROUGHT ON BY a psychological
| source, that may or may not continue to exist.
|
| The last part is in my experience the thing people are
| missing that creates a lot of arguments, especially
| around medication. I have gone through lots of trauma
| growing up, and I only recently learned of the role of
| the interplay between the physical and the mental. I had
| always eschewed medication - and I still think it to be
| /mostly/ a first-aid treatment. There's nothing to say
| that someone has a long-term physiological imbalance, or
| one that we don't know how to treat. Therefore its valid
| if someone needs to be on a medication for the long term.
| The saying goes amongst people I know - "If you can't
| make your own neurochemicals, store bought is fine.".
|
| For me, medication allowed the relative calm in order to
| directly tackle and address childhood trauma and patterns
| of thinking that ultimately result in acute depression
| and anxiety. Unawareness of those triggers or ways to
| deal with them leads that acute depression/anxiety to
| become chronic over time, where no trigger is necessary.
|
| CBT (cognative behavioral therapy) is a very good way to
| identify patterns of thoughts or thinking that doesn't
| make sense, or create a reaction that is far outside of
| the range that a person would expect. You end up having
| this moments of unclear thoughts when digging into past
| events, or things that upset you, or thoughts about
| yourself. I have learned to relish those - that means I'm
| learning something or making a connection that I didn't
| have before.
|
| Finally, approaching entirely from the psychological side
| does not always give results. Having gone through lots
| and lots of cognative behavioral therapy, I'm fully aware
| when I'm being irrational or have a stronger than
| expected emotional reaction to things. I even apologize
| while I'm doing it! But it wasn't until I dug into a
| different type of therapy, EMDR, that started to approach
| from the physical side of things. I started to learn to
| notice things that were making my hands ball up in anger,
| even though I didn't notice them before. I learned that I
| dissociate sometimes and don't form memories of when I'm
| upset, which severely hampers my ability to address the
| things. All of this to say, its complex. It all has
| underlying rational reasons behind it, and seeking out
| information and building your own mental model of, well,
| your mental model, is a very helpful way to go about it,
| though it takes a long time.
|
| So try medication, try therapy, try different types of
| therapy. Its extremely difficult. Its sort of like
| performing surgery on yourself. But there is always
| another path and more things to learn about yourself.
| golergka wrote:
| This is not an anonymous nickname, so I wouldn't be able
| to give you an honest and full answer.
| derefr wrote:
| For some people, these diseases (depression, anxiety, ADHD,
| bipolar, schizophrenia, OCD, intermittent explosive
| disorder, etc.) are lifelong maladies present from birth;
| where even if the disease only "showed up" later on, it is
| known from the person's genetics/neuroanatomy/etc. that it
| was inevitable for this person to get them, eventually,
| regardless of environment or lifestyle.
|
| Such cases are no more adaptive than Cystic Fibrosis is
| adaptive. They're malfunctions.
| j4nt4b wrote:
| I would hesitate before calling these conditions
| "lifelong maladies present from birth". It's much more
| accurate to call them predispositions that may or may not
| manifest. And even so, the degree of manifestation may
| depend on the degree of trauma, addiction, or other
| challenges the person happens to face in life. This
| variation is what makes me doubt any clean division into
| adaptive/maladaptive cases. Not everyone so predisposed
| is triggered into these mental reactions through their
| life experiences, and not everyone who is so diagnosed is
| a lost cause, and furthermore, those who can manage their
| conditions may take offence at being called
| "malfunctioning" when they did in fact "adapt".
| derefr wrote:
| > those who can manage their conditions may take offence
| at being called "malfunctioning" when they did in fact
| "adapt".
|
| People don't malfunction; bodies do. People are
| (cybernetic) systems, composed of a mind and a body; but
| people's bodies _specifically_ , when taken on their own
| --including their brains, when taken on their own as
| organs!--are just complex machines, that can have
| _organic diseases_. (In the case of the brain, we call
| these
| https://en.wikipedia.org/wiki/Organic_brain_syndrome s.)
|
| If your computer spontaneously powers off whenever you
| open hit your keyboard's "A" key, that's a malfunction.
| Computers, as machines, aren't supposed to do that. If
| you avoid ever hitting the "A" key, _you_ might have
| worked around the problem, but the problem itself is
| still present-- _the computer_ , considered as a
| standalone machine rather than a cybernetic operator-
| machine system, is still malfunctioning.
|
| If you have an SNP in the gene DDC, causing
| https://en.wikipedia.org/wiki/Aromatic_L-
| amino_acid_decarbox..., that is a malfunction (or
| manufacturing defect) in your brain-as-machine. _You_ --
| the mind-body system -- might learn to adapt to /work
| around this malfunction; but that doesn't mean the brain-
| as-machine isn't continuing to malfunction. A working
| system can be constructed from unreliable components.
|
| > who is so diagnosed is a lost cause
|
| Who said anything about being a lost cause? For something
| to be maladaptive, it simply has to reduce inclusive
| genetic fitness, such that people with the condition
| reproduce less than people without the condition. That
| says nothing about whether you can live your life with
| the condition.
|
| Whatever part of the human brain thinks getting a
| vasectomy is a good idea, is extremely maladaptive! But
| that's not to say that we don't _prefer_ things that way.
| :)
| texasbigdata wrote:
| Very good book, "the Depths" about depression. It argues it's
| partially an evolutionary response.
|
| Also "quiet" by Susan Cain is even more excellent and
| insightful about introverts.
| tabtab wrote:
| Younger boys who get a lot of exercise consistently perform
| better in school on average. The "problem" is that girls don't
| need as much exercise. Coordinating the difference confounds US
| schools.
| HeckFeck wrote:
| Honestly, this squares with personal experience. I've had long
| periods of anxiety, which I'd describe as perceiving outside
| things as greater threats than they are, excessive worry and
| overthinking and withdrawal from outside world. I've also endured
| depression, that is overmuch despair and lack of willpower to
| complete even simple tasks.
|
| It plagued me for years, badly affecting much of my personal
| life. I had some therapy (for 3 months), and interestingly a
| doctor actually voiced the same view put forward in this article.
| I never took medication.
|
| Latterly, after gaining more life experience and connecting some
| dots, I realised much of this was fed by my environment when I
| was growing up. I realised this comparing outcomes with others
| who had stabler, supportive homes. Bad circumstances leading to
| social ostracisation, which meant I never developed social skills
| well, which meant I always dreaded social contact. This fed an
| endless anxiety cycle.
|
| After ten painful years, wrangling and working through it, I've
| eventually managed to make better friendships. As a result, my
| anxiety has dropped and my overall social ability improved.
| Nowadays, social contact has been reduced and I've been forced to
| stay in my childhood home thanks to "lockdown". Curiously, I've
| once again had more of the depression-like symptoms.
|
| I wonder how much of these afflictions are brought on by poor
| family environments, and even when they are stronger the parents
| providing little personal input into children's lives. Lack of
| community generally and increased personal isolation. I'd put it
| forward that medicalisation isn't the answer to all of life's
| woes, or the problems we face individually or collectively.
| godelzilla wrote:
| Sure, the science seems obvious. But where's the profit in
| dealing with adversity? The pharma/medical industry has gotta
| keep pumping pills for cash. \s
| sudofail wrote:
| Couldn't a person have a biological makeup that predisposes them
| to experience greater or lesser adversity? If mental disorders
| are adaptive responses, that doesn't seem to rule out that some
| people may be more prone to interpreting situations as
| adversarial.
| podgaj wrote:
| Yes, a genetic make up.
|
| https://onlinelibrary.wiley.com/doi/full/10.1002/ajmg.b.3276...
| tapland wrote:
| Yes of course one could have more or less of a response.
| Situations and circumstamces (we're talking about entire lives
| worth of experiences) vary so much though that it would be
| impossible for an outsider to state _you are weaker_ based on
| the limited knowledge you can have about another person.
| mlang23 wrote:
| PTSD is quite obviously a response to adversity, that is already
| implied by the name! What am I missing here? Why is this news?
| MaxBarraclough wrote:
| The point is whether it's _adaptive_ , i.e. whether it has
| evolved because it is beneficial (such as our pain aversion),
| rather than arising as an unfortunate bug in the system (such
| as cystic fibrosis, a genetic disorder which seems pretty
| clearly not to be adaptive).
| mamon wrote:
| Of course PTSD is beneficial: it gets you discharged from
| military, for example, so the chances of you being in the
| situation where someone is shooting bazooka at you drop to
| zero.
|
| In general PTSD helps you avoid traumatic experience in
| future.
| blame_lewis wrote:
| In many interpersonal relationships, a trauma response
| causes you to become _more_ liable to ending up in the same
| situation, not less. Do not underestimate how many people
| end up reliving their trauma over and over because they can
| 't overcome that response.
| dboreham wrote:
| Extra points for using the word "bazooka".
| [deleted]
| [deleted]
| bjornsing wrote:
| Well we surely did not evolve to be happy and content, that's for
| sure. Sounds to me like a good bet that most mental disorders are
| adaptations to adversity in evolutionary time, that are often
| maladaptive in modern society.
| molticrystal wrote:
| We could rationalize an opposite hypothesis as well, perhaps they
| are adaptive responses to lack of adversity. It would be
| interesting if a good experiment can be formulated to figure it
| out.
|
| One rationale is that life for billions of years and humans for
| millions have faced harsh conditions never letting us rest and
| relax for long.
|
| So if we are sitting still, relaxing, often it meant something
| must be wrong(physically or mentally) and in less sympathetic
| times mental illness would encourage culling, either by the tribe
| or yourself to ensure the limited resources were spent on people
| who are contributing more physical action.
|
| Roles that didn't have to deal with as much adversity obviously
| formed eventually, but they took a long time to stabilize, likely
| being poorly tolerated in most ages, and if the hypothesis was
| true, were plagued more with the OP's issues.
| nicoffeine wrote:
| I have had similar thoughts. I think that's why exercise is so
| much more effective than medicine - it's making your lower
| physiological self think that you are doing something important
| and exciting. It also explains why people get so invested in
| the drama of others. In economically developed countries, we
| have far fewer life and death situations that help us
| appreciate it when things are going well.
|
| The other difficulty is that our higher order functions know
| that exercise is, in the short term, a waste of energy and
| time. It's not getting us any more resources. I include myself
| in the subset of people with impulse and procrastination
| issues, which makes it very difficult to invest in things that
| pay off over the long term. Depression for me is being stuck in
| that hole, knowing there may be a way to feel better, but
| believing the world would be better if I was dead. Maybe my
| evolutionary contribution would have been as a martyr if I
| lived in a different circumstance.
|
| More generally, healthcare suffers from the idea that there is
| "a" population. Our brains and bodies are unique, and until
| they can identify types of brain patterns and perform studies
| against those, it's really throwing pills at someone and hoping
| for the best. Some parts of science have entered into a
| dangerous dogmatic phase of "this is how we've always done it"
| which is the opposite of the point.
|
| I would really like to see the mental health community rally
| behind getting people into recovery-style support groups where
| people encourage each other to socialize, eat healthier, and
| get more exercise. That would put all three of the most
| effective ways to fight depression and anxiety into practice.
| Of course then the problem is that prescribing virtually free
| services isn't in the economic interest of for-profit systems.
| carabiner wrote:
| The money quote:
|
| > Study author Kristen Syme, a recent WSU Ph.D. graduate,
| compares treating anxiety, depression, or PTSD with
| antidepressants to medicating someone for a broken bone without
| setting the bone itself. She believes that these problems "look
| more like sociocultural phenomena, so the solution is not
| necessarily fixing a dysfunction in the person's brain but fixing
| dysfunctions in the _social world_. "
|
| This is EXACTLY what Kaczynski said:
|
| > The concept of 'mental health' in our society is defined
| largely by the extent to which an individual behaves in accord
| with the needs of the system and does so without showing signs of
| stress ... Instead of removing the conditions that make people
| depressed, modern society gives them antidepressant drugs. In
| effect, antidepressants are a means of modifying an individual's
| internal state in such a way as to enable him to tolerate social
| conditions that he would otherwise find intolerable.
| vorpalhex wrote:
| Kaczynski ends up positing a kind of return to the natural
| state as the ultimate solution (which he basis his actions on).
| The issue being that historically, these problems existed in
| earlier times even if not discussed in detail. Kaczynski blames
| "the state of the world" without ever listing some state where
| the problem didn't exist.
|
| > "Research on depression, anxiety, and PTSD, should put
| greater emphasis on mitigating conflict and adversity and less
| on manipulating brain chemistry."
|
| Whereas Kaczynski blames society, the world at large, the paper
| sets these up as smaller addressable issues. You can identify
| "kid B needs extra recess" more readily than abolish schools as
| Kaczynski calls for.
| swebs wrote:
| He's a pretty agreeable guy if you ignore all the bombings.
| Nav_Panel wrote:
| Yeah and also what psychoanalysts have said for the last 100+
| years. All Kaczynski offers is a normative stance.
| throwaway0a5e wrote:
| So why didn't anxiety, depression and PTSD abound in historical
| societies that were always at risk of some bad thing (usually
| famine but also sometimes invasion)?
|
| Bad stuff has always happened and always will happen. Something
| about modern society makes us bad at dealing with it in a healthy
| way.
|
| I don't doubt that there might be some mismatch between the
| environment our biology is optimized for and the one we live in
| now but it seems like these conditions weren't common, or if they
| were they weren't a problem, among our ancestors who lived under
| different circumstances.
| calimac wrote:
| Ibogaine treatment for Anxiety, Depression, and PTSD is amazingly
| effective. Individuals who have taken treatment express years of
| growth packed into days.
|
| https://ibogaineclinic.com https://youtu.be/ltJfEfnM2ek
| johnnujler wrote:
| It took humans thousands of years to adapt to the side-effects of
| the agricultural(Neolithic) revolution
| (https://www.discovermagazine.com/planet-earth/the-worst-
| mist...). I think we are in a similar situation--psychological
| revolution?--where the side-effects due to social media,
| globalization, and other related phenomenons are starting to
| change the landscape. My guess is we will soon see that the
| plateau we have attained in the form of psychological disorders
| will slowly fade away in couple more generations as people start
| adapting to this kind of stress. Maybe our generation is
| evolution's transition point? At least I hope that it is, I've
| never seen this at this level of intensity with my
| grandparents'/parents' generation and I do not want to see this
| with the next generation.
| billman wrote:
| Another thing to think about is that these responses may cross
| generations. i.e the anxiety someone experiences today may be due
| to trauma suffered by thier grandparents. The mind is a wonderful
| thing, but there is so much that we don't understand about
| it/ourselves.
| podgaj wrote:
| This happens through epigentic changes, not through the mind or
| the brain.
|
| https://www.sciencemag.org/news/2019/07/parents-emotional-tr...
| raindeer3 wrote:
| "Anxiety may be due to chronic activation of the fight or flight
| system. PTSD may occur when trauma triggers the freeze response
| which helps animals disconnect from pain before they die, and
| depression may be a chronic activation of that same freeze
| response." Isn't this a quite good definition of disorders? If a
| system is chronically activated when it should not, it seems like
| a disorder.
| fnord77 wrote:
| when these conditions persist after the adversity has passed,
| that's maladaptive.
| dredmorbius wrote:
| Is a leg that remains fractured after a physical shock has
| passed also maladaptive?
| fnord77 wrote:
| if it doesn't heal in some reasonable amount of time after
| the trauma and remains fractured indefinitely, then yes.
| holidayacct wrote:
| Anxiety is a disorder of the nervous system that is a by-product
| of civilization. We are one of the only mammals that gets
| anxiety, if you get anxiety in the wild you won't be alive much
| longer.
|
| Depression and PTSD are not responses to adversity. If you face
| adversity and suffer depression or PTSD you were raised
| psychologically weak in a way that is dangerous to you.
|
| There are people who have survived civil wars, drought and mass
| starvation all over the world that don't have these problems get
| out of your bubble.
| tsimionescu wrote:
| > There are people who have survived civil wars, drought and
| mass starvation all over the world that don't have these
| problems get out of your bubble.
|
| And similarly, there are people who have been traumatized by
| the same events.
|
| In fact, there are war heroes who have taken bullets for their
| comrades, saved platoons, jumped at the enemy, and have been
| stricken with PTSD - if you think these people are "weak", then
| you probably also consider people who get cancer to be of
| inferior stock, right?
| podgaj wrote:
| It is so shocking to me that people do not think genetic
| diversity exists without the human species.
| auganov wrote:
| If you have two people subject to same circumstances and one
| experiences significantly more distress they are weaker in
| some sense.
|
| Doesn't mean they're less virtuous in what they have done.
| But obviously everybody should strive to be the one that
| comes out unscathed.
| dredmorbius wrote:
| Addressing only one of your dubious points, there is a
| considerable scientific literature on anxiety response in
| animals.
|
| https://scholar.google.com/scholar?q=anxiety%20response%20an...
| MaxBarraclough wrote:
| This strikes me as a pretty clumsy article.
|
| > What if mental disorders like anxiety, depression, or post-
| traumatic stress disorder aren't mental disorders at all?
|
| Of course they're disorders. That's why they deserve treatment.
| This bears no connection to the question of whether they're
| adaptive. Our capacity for physical pain is adaptive, but doctors
| still treat pain.
|
| > With a thorough review of the evidence, they show good reasons
| to think of depression or PTSD as responses to adversity rather
| than chemical imbalances.
|
| Besides clueless commentators on the Internet, who is suggesting
| depression is simply a matter of 'chemical imbalance'? If that
| were the case, it wouldn't be brought on by loneliness, and it
| wouldn't be treated with CBT and talking therapy.
| podgaj wrote:
| And who is to say CBT does not effect chemicals in the brain
| and body! Of course it does! everything environmental effects
| the chemicals in our body. If you give someone meth they will
| have anxiety, if you drink too much you will have depression.
|
| The state of understanding the gene-environment interaction is
| so backwards and slow to catch up with the science it is a
| crime.
| npwr wrote:
| > Besides clueless commentators on the Internet, who is
| suggesting depression is simply a matter of 'chemical
| imbalance'? If that were the case, it wouldn't be brought on by
| loneliness, and it wouldn't be treated with CBT and talking
| therapy.
|
| Most of (all?) chemical depression treatments are based on the
| serotoninergic depression hypothesis that has never been
| verified. In the recent years more and more arguments come
| directly against this hypothesis. Yet SSRIs are still the first
| line of treatment for depressive patients.
|
| https://en.wikipedia.org/wiki/Major_depressive_disorder#Path...
| raducu wrote:
| Besides raving on and on about ADHD, the article offers little
| actionable stuff, dubious reasoning and outright falsehoods at
| places (like the fact that antidepressants are no better than
| placebo).
| disgruntledphd2 wrote:
| I wouldn't say that that is a false statement, there's been a
| bunch of research in the area, mostly started by this paper:
| https://www3.nd.edu/~ghaeffel/Kirsch2002%20Prevention%20&%20...
|
| Note that the above is an analysis of the data used to approve
| the medications from the FDA, so likely to be optimistic.
|
| The headline finding is that compared to an active placebo
| (i.e. one with similar side effects), the benefits of SSRIs are
| very small.
|
| However, if you have a diagnosis of MDD, there is more evidence
| for an effect (although it's still pretty small).
|
| It's a difficult subject to study correctly, because of the
| strong commercial pressures (like most drug studies, to be
| fair), but depression does seem relatively placebo responsive,
| which would suggest either a connection to inflammation or the
| body's opioid system.
|
| This does not mean that people should stop taking anti-
| depressants, I'm not a medical doctor etc, but there is some
| research to support the assertion around SSRIs and placebo in
| the article.
| dathinab wrote:
| Anxiety & depression might be useful if handled well but if
| not...
|
| The problem is often on the line of you get depression & anxiety
| as a symtom of some other problems if you fix the problems fine.
| If you don't it can get out control and then you _can become
| conditioned to do "bad" responses to all kind of things making
| the symptom a illness itself_. And making it really hard to get
| out of it.
|
| Or at least this is how it _often did look like to me_ when I
| looked at people with depression & anxiety.
|
| Just to be clear with "bad" responses I mainly mean thinks like
| avoiding problems instead of fixing (or sidestepping) them making
| it with every time you do so harder to "fix" that underlying
| problem in the future.
| lazyeye wrote:
| So much of what we think is knowledge is actually just a
| construct to allow someone to make some money. You cant make
| billions of dollars selling pills through educational reform.
| Carbs have a longer shelf-life, high profit margin and are hunger
| inducing so fat was demonised. Recycling doesnt work because its
| not cost effective but the plastics industry pushes it to shift
| responsibility away allowing them to fill our world with garbage.
| You cant make money with treatments out of patent so meds like
| chloroquine are demonised with cherry-picked research. We are
| swimming in an ocean of garbage presented to us as fact.
| SzamarCsacsi wrote:
| _" When it comes to what labels we use, a change is welcome.
| Mental health recovery in part depends on whether patients
| believe they can get better. Telling our patients that their
| symptoms may be tied to a healthy response to adversity could be
| very encouraging."_
|
| I find it the exact opposite. For me it seems easier to fix a
| mental disorder in my brain than to bring the necessary
| sociocultural changes in the world to mitigate my problems.
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